WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) along Sens. Brian Schatz (D-HI), Ben Cardin (D-MD), Cindy Hyde-Smith (R-MS), John Thune (R-SD), and Roger Wicker (R-MS) have introduced bipartisan legislation to expand telehealth services through Medicare, improve health outcomes, make it easier for patients to connect with their doctors, and help cut costs for patients and providers. Companion legislation has been introduced in the House of Representatives by U.S. Reps. Mike Thompson (D-CA), Peter Welch (D-VT), David Schweikert (R-AZ), and Bill Johnson (R-OH).

“I’ve seen firsthand how hard it can be for Virginians to access health care in rural or underserved communities,” said Sen. Warner. “From my time as Governor through my years in the Senate, I’ve constantly pushed to use innovation to increase health care accessibility for Virginians. This legislation will allow more individuals across Virginia and our country to take advantage of telehealth services that require less travel time and provide affordable, quality care.”

 In studies, telehealth has been shown to improve care and patient satisfaction while reducing hospitalizations. The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 builds on the progress made in recent years to increase the use of telehealth through Medicare. Specifically, the legislation would:

• Provide the Secretary of Health and Human Services (HHS) the authority to waive telehealth restrictions when necessary;
• Remove geographic and originating site restrictions for services like mental health and emergency medical care;
• Allow rural health clinics and other community-based health care centers to provide telehealth services; and
• Require a study to explore more ways to expand telehealth services so that more people can access health care services in their own homes.

Sen. Warner, an original cosponsor of the 2016 CONNECT for Health Act, has been a longtime advocate for increased access to health care through telehealth. Last year, he successfully included a provision to expand telehealth services for substance abuse treatment in the Opioid Crisis Response Act of 2018. In 2003, then-Gov. Warner expanded Medicaid coverage for telemedicine statewide, including evaluation and management visits, a range of individual psychotherapies, the full range of consultations, and some clinical services, including in cardiology and obstetrics. Coverage was also expanded to include non-physician providers. Among other benefits, the telehealth expansion allowed individuals in medically underserved and remote areas of Virginia to access quality specialty care that isn’t always available at home.

The CONNECT for Health Act of 2019 has the support of more than 100 organizations including AARP, ACT | The App Association, Alliance for Connected Care, American College of Emergency Physicians, American Hospital Association, American Medical Association, American Medical Group Association, American Nurses Association, American Psychiatric Association, American Psychological Association, American Telemedicine Association, America’s Health Insurance Plans, Connected Health Initiative, Federation of American Hospitals, Health Innovation Alliance, Healthcare Information and Management Systems Society (HIMSS), National Alliance on Mental Illness, National Association of Community Health Centers, National Association of Rural Health Clinics, and the Personal Connected Health Alliance.

“By reducing geographic and originating site restrictions in Medicare, the CONNECT for Health Act of 2019 will bridge the miles between patients and care, mitigate workforce shortages, and most importantly improve outcomes at lower costs for our nation’s vulnerable populations. Coupled with our national priority of expanding broadband access, these efforts will enable all Americans to enjoy better health and health related prosperity,” said Dr. Karen Rheuban, Director of the UVA Center for Telehealth.

“This legislation would benefit patients by removing antiquated restrictions in the Medicare program that prevent physicians from using widely available medical technology that has become commonplace in the past decade. Increased access to telehealth is urgently needed to help meet the health needs of the swiftly changing demographics of our senior population. The CONNECT for Health Act’s expansion of telehealth coverage in the Medicare program also will spur increased investment and innovation in delivery redesign to benefit all patients,” said Patrice A. Harris, M.D., M.A., President of the American Medical Association. “The AMA strongly supports the CONNECT for Health Act of 2019 and applauds Senators Schatz, Wicker, Cardin, Thune, Warner, and Hyde-Smith for their continued leadership on telehealth issues, and we look forward to seeing this vital bill advance in Congress.”

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) is pressing Facebook CEO Mark Zuckerberg to reverse a policy allowing politicians and elected officials to run demonstrably false advertisements on the platform. 

“The public nature of broadcast television, radio, print, cable, and satellite ensured a level of accountability for traditional political advertisements. In addition to being broadly accessible to the electorate, these communications are accessible to the press, fact-checkers, and political opponents through media monitoring services that track broadcast content across television and radio markets. As a result, strong disincentives exist for a candidate to disseminate materially false, inflammatory, or contradictory messages to the public,” the Senator wrote in a letter to Zuckerberg, sent late last evening. “By contrast, social media platforms tout their ability to target portions of the electorate with direct, ephemeral advertisements—often on the basis of private information the platform has on individual users, facilitating political advertisements that are contradictory, racially or socially inflammatory, or materially false, without the same constraints as more traditional communications mediums, and without affording opposing candidates an equal opportunity to respond directly in front of the same targeted audience.”

“In making strides not to continue contributing to the coarsening of our political debate, and the undermining of our public institutions, at a minimum, Facebook should at least adhere to the same norms of other traditional media companies when it comes to political advertising. In defending its refusal to remove false political advertisements by candidates, Facebook has pointed to provisions of the Communications Act that prohibit broadcast licensees from rejecting or modifying candidate ads, regardless of their accuracy. This comparison is inapt. Broadcast licensees face legal requirements to run these ads – in addition to a range of other obligations – as a condition of holding federal spectrum licenses. The prohibition to reject or modify the ad accompanies a statutory obligation to air ads of qualified federal candidates in the first place,” Sen. Warner concluded. “A more appropriate comparison for a platform like Facebook would be cable networks, which (like Facebook) face no such prohibition on rejecting demonstrably false advertisements from political candidates – nor are they bound by related obligations such as rules on advertising rates and reasonable access requirements. Therefore, the industry norms Facebook should heed would more aptly be those followed by not by local broadcasters, but by cable networks. Notably, CNN refused to air the same demonstrably false ad Facebook allowed the Trump campaign to run. To the extent Facebook takes inspiration from the norms of local broadcasters, it should likewise require that candidates provide documentation of claims made in their advertisements.” 

Sen. Warner also posed a series of questions seeking to clarify and define the Facebook policy, including: 

• Under this policy, how is Facebook defining “politician”? What steps have you taken to prevent abuse of this definition?

• Mr. Nick Clegg, Facebook’s VP of Global Affairs, has noted that this policy has exceptions for speech which “can lead to real-world violence and harm” or “endangers people.” How is Facebook defining these terms? 

• Unlike online intermediaries like Facebook, traditional media outlets can be sued for defamation for the advertisements they run. Because of this, traditional media outlets have generally adopted norms of refusing to run advertisements with clear falsehoods, and of taking down ads where an opposing campaign or fact-checking organization has shown an ad to be false. Would a regulatory regime establishing greater parity in liability between Facebook and traditional media outlets serve to simplify Facebook’s policies in this sphere?

• Will you commit to provide ad targeting information, as required under the Honest Ads Act, to better allow opposing campaigns to “correct the record” in responding to potentially misleading ads?

Sen. Warner has written and introduced a series of bipartisan bills designed to protect consumers and reduce the power of giant social media platforms like Facebook. The Designing Accounting Safeguards to Help Broaden Oversight And Regulations on Data (DASHBOARD) Act, bipartisan legislation with Sen. Josh Hawley (R-MO), will require data harvesting companies such as social media platforms to tell consumers and financial regulators exactly what data they are collecting from consumers, and how it is being leveraged by the platform for profit.? The Deceptive Experiences To Online Users Reduction (DETOUR) Act,? bipartisan legislation with Sen. Deb Fischer (R-NE), will prohibit large online platforms from using deceptive user interfaces, known as “dark patterns” to trick consumers into handing over their personal data. The Honest Ads Act, bipartisan legislation with Sens. Amy Klobuchar (D-MN) and Lindsey Graham (R-SC) will help prevent foreign interference in future elections and improve the transparency of online political advertisements. The Augmenting Compatibility and Competition by Enabling Service Switching (ACCESS) Act, bipartisan legislation with Sen. Hawley and Sen. Richard Blumenthal (D-CT), will encourage market-based competition to dominant social media platforms by requiring the largest companies to make user data portable – and their services interoperable – with other platforms, and to allow users to designate a trusted third-party service to manage their privacy and account settings, if they so choose. 

The full text of Sen. Warner’s letter to Zuckerberg appears below. A copy of the letter is available here. 

Mr. Mark Zuckerberg

Chief Executive Officer

Facebook, Inc.

1 Hacker Way

Menlo Park, CA 94025

Dear Mr. Zuckerberg,

I write you in the context of an ongoing debate about the impact of social media on our public institutions and on our political discourse. In the last two weeks, one facet of this debate has been the extent to which platforms like Facebook allow politicians to spread deliberate falsehoods through paid political advertising. While Facebook’s advertising rules have long prohibited ads with “deceptive, false, or misleading content” – relying on its “third-party fact-checkers” to identify violations of these policies – Facebook subsequently revised these rules to exempt political ads run by politicians through a policy that withholds such ads from third-party fact-checker review.

The consequence of these policies came into sharp focus early this month, after a series of ads purchased by the Trump 2020 campaign containing falsehoods about former Vice President Biden were found in Facebook’s political ad archive. I appreciate that these ads were discovered only as a result of Facebook’s decision to voluntarily implement some of the Honest Ads Act, bipartisan legislation I drafted with Senator Klobuchar and the late Senator John McCain, which has allowed researchers, opposing campaigns, and journalists to track political advertising on Facebook. However, Facebook’s refusal to provide targeting information used for political ads, and widely-reported defects in the API preventing large-scale data analysis, underscore that piecemeal, optional steps by individual companies are insufficient to protect our democracy from bad actors exploiting social media; I will continue to press to pass the Honest Ads Act into law and press your company to fully comply with the provisions in the Act. 

Transparency, however, is but one value undergirding our nation’s political discourse. A whole host of norms and laws have structured the public sphere – the space within civil society in which we debate important political, social, and cultural issues. The public sphere has been shaped by a mix of legal rules (traditionally based in communications and campaign finance laws) and norms that have worked to promote transparency, public deliberation and debate, openness, diversity of opinion, and accountability.

Undeniably, these norms have come under major strain in recent years, from a variety of different directions. Among political actors, norms of decency and probity – strained in the best of times – have been routinely flouted. This is particularly evident in today’s digital age. As an avid user of digital media (and shrewd practitioner of how to exploit it), President Trump has in many ways helped to undermine these norms – and other candidates have chosen to follow suit.  

But it is also true that these norms have been undermined at least in part because of the nature, architecture, policies, and operation of platforms like Facebook. The public nature of broadcast television, radio, print, cable, and satellite ensured a level of accountability for traditional political advertisements. In addition to being broadly accessible to the electorate, these communications are accessible to the press, fact-checkers, and political opponents through media monitoring services that track broadcast content across television and radio markets. As a result, strong disincentives exist for a candidate to disseminate materially false, inflammatory, or contradictory messages to the public. By contrast, social media platforms tout their ability to target portions of the electorate with direct, ephemeral advertisements—often on the basis of private information the platform has on individual users, facilitating political advertisements that are contradictory, racially or socially inflammatory, or materially false, without the same constraints as more traditional communications mediums, and without affording opposing candidates an equal opportunity to respond directly in front of the same targeted audience. 

The consequences of Facebook’s decision not to apply the same standards to political advertisements on its platform are potentially enormous: Today, 79 percent of online Americans – 68 percent of all Americans – are Facebook users. Over 160 million Americans use Facebook on a daily basis, spending an average of 35 minutes on the site each day. By contrast, the most-watched television broadcast in U.S. history – Super Bowl XLIX – was viewed by 114 million Americans. In the 2016 election, spending on digital advertising reached $1.4 billion, a 789 percent increase from the $159 million spent in 2012. The use of social media – and the internet more broadly – to inform the decisions of the electorate only heightens the need for scrutiny of the ads placed on those sites.

In making strides not to continue contributing to the coarsening of our political debate, and the undermining of our public institutions, at a minimum, Facebook should at least adhere to the same norms of other traditional media companies when it comes to political advertising. In defending its refusal to remove false political advertisements by candidates, Facebook has pointed to provisions of the Communications Act that prohibit broadcast licensees from rejecting or modifying candidate ads, regardless of their accuracy. This comparison is inapt. Broadcast licensees face legal requirements to run these ads – in addition to a range of other obligations – as a condition of holding federal spectrum licenses. The prohibition to reject or modify the ad accompanies a statutory obligation to air ads of qualified federal candidates in the first place.

A more appropriate comparison for a platform like Facebook would be cable networks, which (like Facebook) face no such prohibition on rejecting demonstrably false advertisements from political candidates – nor are they bound by related obligations such as rules on advertising rates and reasonable access requirements. Therefore, the industry norms Facebook should heed would more aptly be those followed by not by local broadcasters, but by cable networks. Notably, CNN refused to air the same demonstrably false ad Facebook allowed the Trump campaign to run. To the extent Facebook takes inspiration from the norms of local broadcasters, it should likewise require that candidates provide documentation of claims made in their advertisements.

Facebook’s apparent lack of foresight or concern for the possible damages caused by this policy concerns me. Thus, I am asking for a response from the company regarding the details of this policy and efforts to avert these negative effects: 

• Under this policy, how is Facebook defining “politician”? What steps have you taken to prevent abuse of this definition?

• Mr. Nick Clegg, Facebook’s VP of Global Affairs, has noted that this policy has exceptions for speech which “can lead to real-world violence and harm” or “endangers people.” How is Facebook defining these terms? 

• Unlike online intermediaries like Facebook, traditional media outlets can be sued for defamation for the advertisements they run. Because of this, traditional media outlets have generally adopted norms of refusing to run advertisements with clear falsehoods, and of taking down ads where an opposing campaign or fact-checking organization has shown an ad to be false. Would a regulatory regime establishing greater parity in liability between Facebook and traditional media outlets serve to simplify Facebook’s policies in this sphere?

• Will you commit to provide ad targeting information, as required under the Honest Ads Act, to better allow opposing campaigns to “correct the record” in responding to potentially misleading ads?

 Thank you for your time and I look forward to receiving your responses within the next two weeks.

Sincerely,

Mark R. Warner

U.S. Senator

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WASHINGTON – Senate Democratic Leader Chuck Schumer (D-NY) and Senator Mark Warner (D-VA), along with Senate Committee on Health, Education, and Labor Ranking Member Patty Murray (D-WA), and Senate Committee on Finance Ranking Member Ron Wyden (D-OR), today announced that Senate Democrats will use their authority under the Congressional Review Act to force a vote on the Senate floor this week, as early as Wednesday, on a resolution to that would roll back the Trump administration’s rule on 1332 waivers, which the Trump Administration is using to sabotage Americans’ health care and undermine the critical pre-existing condition protections that more than 130 million Americans rely on. The Trump administration’s rule, if left in place, allows states to greenlight junk insurance plans that don’t fully protect people with pre-existing conditions, don’t cover essential health benefits like prescription drugs and maternity care, and raise out-of-pocket costs on many American families. The rule also lets states promote junk plans that can charge people more if they have a pre-existing condition or refuse to offer coverage for specific benefits. These plans would destabilize our insurance markets and could limit insurance access and raise costs for millions of Americans.

The vote on the resolution to overturn the Trump administration’s rule, which Democrats will force under the Congressional Review Act,  is one of the most significant policy changes the Senate will consider in Majority Leader McConnell’s legislative graveyard. Leader McConnell – long before the House impeachment inquiry – turned the Senate into a legislative graveyard for the priorities of the American people.

“Earlier this year, I was proud to lead the effort to introduce a CRA resolution to overturn the Trump Administration’s latest attempt to undermine our healthcare system,” said Senator Warner. “Today, I’m glad to announce that as a result of this effort, we’ll be able to give every Senator the opportunity to stand up for folks with pre-existing conditions. Many of my colleagues on the other side of the aisle have said that they support the Affordable Care Act protections that so many folks count on. Well, this vote is an opportunity for them to prove it. I urge my colleagues to stand with the millions of Americans with pre-existing conditions by voting to reverse this harmful effort by the Trump Administration.”

“This week, the Senate will hold one of the most significant votes of the year: we will finally see where Republicans stand on the Trump administration’s efforts to sabotage the health care of millions of Americans with pre-existing conditions. It is preposterous that the Trump administration claims to care about preserving pre-existing condition protections for millions of Americans while simultaneously peddling shoddy, substandard junk plans that undermine and weaken those very protections,” said Leader Schumer.  “I say to my Republican colleagues: stand up to the sabotage or stop swindling the American people with your empty promises of support for protections for Americans with pre-existing conditions. With this vote, the Senate Republicans who say they care about preserving pre-existing condition protections will have a chance to prove it to the American people. I urge my colleagues to step up to the plate and join Senate Democrats in supporting this critical resolution.”

“Democrats are putting an end to Republicans’ transparent health care charade and forcing every Senator to go on the record once and for all about whether they will fight for families’ health care and stand up for patients with pre-existing conditions—even if it means standing up to President Trump,” said Senator Murray. “Families and patients across the country are going to be watching very carefully and taking note of who votes to protect their health care, and who sides with President Trump and big insurance companies by voting to uphold his rule promoting junk plans and undermining protections for pre-existing conditions.”

“Americans want to know where their elected officials stand on protecting those with pre-existing conditions. This week they will have an answer,” said Senator Wyden. “The Senate will be voting on a Trump rule that throws the door open to discrimination, leaving those who need health care most at the mercy of unscrupulous insurance companies. I urge my colleagues to join Democrats and end this perversion of the law – people with pre-existing conditions are counting on it.”

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WASHINGTON — U.S. Sen. Mark R. Warner (D-VA), Co-Chair of the Senate Aerospace Caucus, met with Clayton Turner, Director of the NASA Langley Research Center in Hampton, Virginia, at Sen. Warner’s office in Washington, D.C.

In the meeting, Sen. Warner and Director Turner discussed NASA Langley’s FY20 budget as well as NASA’s work in unmanned systems. Additionally, they spoke about importance of educating and inspiring the next generation to continue NASA’s work, and Director Turner provided an update on the Artemis program – a mission to land the first woman and next man on the Moon by 2024, using innovative technologies to explore more of the lunar surface than ever before.

“From the earliest days of the Space Program, NASA Langley has played a crucial role supporting NASA’s mission,” said Sen. Warner. “Director Turner and I agree that Congress must continue to support the important work that’s happening at the facility, as well as the business ecosystem of innovative aerospace companies that’s developed in Virginia, and I’m committed to fighting for those priorities in the Senate.”

This meeting follows the September approval of the FY2020 Commerce, Justice, Science, and Related Agencies (CJS) Appropriations Act by the Senate Committee on Appropriations. This legislation would determine NASA Langley’s budget for the next fiscal year, and would authorize funding for several NASA priorities, including the Climate Absolute Radiance and Refractivity Observatory Pathfinder Mission (CLARREO-PF) – a climate change monitoring technology that is scheduled to launch to the International Space Station in 2023.

Sen. Warner has advocated for policies that invest in long-term research and development in aeronautics. Last year, he and Sen. Jerry Moran (R-KS) introduced the Aeronautics Innovation Act to help boost innovation, research, and development in the aeronautics industry by providing a five-year funding commitment to supplement research and advance innovation in the field.

Turner was appointed Director of NASA Langley in September 2019. As center director, he leads a diverse group of about 3,400 civil servant and contractor scientists, researchers, engineers and support staff, who work to make revolutionary improvements to aviation, expand understanding of Earth’s atmosphere, and develop technology for space exploration. From 2015 until his appointment as director, Turner served as Langley’s deputy center director. He is the first African-American to lead NASA Langley in the center’s history.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Jeanne Shaheen (D-NH), and Tammy Baldwin (D-WI) sent a letter urging Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to do more to prevent third-party web brokers from steering individuals towards junk health insurance plans – short-term insurance plans that provide no protections for Americans with preexisting conditions.

On the HealthCare.gov website, CMS includes a link that directs customers towards third-party web broker sites for health care enrollment. The junk plans offered by many of these brokers are not Affordable Care Act (ACA)-compliant and do not have to offer the protections that the ACA mandates, including protections for people with preexisting conditions, such as cancer, diabetes and asthma, or coverage for essential health benefits, including maternity care, substance use disorder treatment and prescription medications. Web brokers have a significant financial incentive to enroll individuals in these deficient plans, and are often able to earn commissions up to four times higher than they would earn enrolling customers in ACA-compliant plans.

In their letter, the Senators highlighted the alarming consequences brought about by the lack of federal oversight of brokers in their letter.

“While federal rules prohibit brokers from displaying junk plans side-by-side with ACA-compliant qualified health plans (QHP), brokers can structure their webpages in ways that steer consumers toward higher-commission products, like junk plans,” wrote the Senators. “Equally concerning, web brokers’ online screening tools can fail to identify instances where a customer is eligible for Medicaid.  In other instances, the screening tools may identify potential Medicaid eligibility, but the web broker platform may continue to push a customer to purchase a junk plan.”

“An effective and well-functioning health insurance market is only possible if consumers are provided transparent information regarding the scope and cost of coverage available, the tax credits available to consumers to offset premiums for comprehensive health plans and the incentives that brokers have for selling various products. Availability of this transparent information is particularly critical in light of your agency’s decision to reduce funding for Health Insurance Marketplace advertising, outreach and education efforts by approximately 90 percent compared to 2016 levels. Your regulatory oversight in this area is vitally important to achieving this effective insurance market. We urge you to take this oversight responsibility seriously,” concluded the Senators.

Sen. Warner has continued to fight against the Trump Administration’s efforts to dismantle health coverage for the more than 3 million Virginians with preexisting conditions. Earlier this month, Sen. Warner urged the HHS and the Centers for Medicare & Medicaid Services (CMS) to limit the proliferation of junk plans. In July, Sen. Warner led the entire Democratic Caucus in a Congressional Review Act resolution to stop the Trump Administration from promoting junk plans. Last month, Sen. Warner filed a discharge petition that will force the Senate to vote on whether to protect Americans with preexisting conditions. The Senate is expected to vote on the resolution next week.

A copy of the letter can be found below.

Dear Secretary Azar and Administrator Verma:

We are writing to raise concerns regarding the lack of oversight from the Centers for Medicare and Medicaid Services (CMS) relating to activities by web brokers to steer individuals toward “short-term limited-duration insurance plans,” also known as “junk plans,” that fail to provide protections for pre-existing conditions or comprehensive coverage of health benefits that patients need. As the 2020 Open Enrollment Period for Health Insurance Marketplace coverage approaches, we are also concerned that CMS has failed to establish any requirements for brokers to disclose to consumers the significantly higher commissions that brokers will receive for enrolling an individual in a junk plan versus an Affordable Care Act (ACA)-compliant qualified health plan (QHP).  

CMS includes a link on the HealthCare.gov website to funnel customers toward third-party web broker sites for direct enrollment. For consumers who are re-directed away from HealthCare.gov and toward the web broker site, it is not clear that CMS has any tracking mechanism in place to determine whether the customer: (1) successfully enrolled in an ACA-compliant QHP, (2) was successfully transferred to a state Medicaid program for Medicaid enrollment, (3) was steered into enrollment in a junk plan or (4) was lost in the shuffle.

The lack of CMS oversight of the connection between web brokers and junk plans is particularly concerning given the evidence that brokers have significant financial incentives to steer patients toward junk plans. The typical commission that a broker can receive for enrolling an individual in a junk plan is often four times as high as the commission that the broker would receive for enrolling a customer into an ACA-compliant QHP that provides comprehensive coverage.  Issuers of junk plans are able to offer these higher commissions because, unlike ACA-compliant QHPs, these plans are not required to meet the ACA’s minimum Medical Loss Ratio (MLR) standards. Under the MLR standards, health plans in the individual market are required to devote at least 80 percent of premium revenue toward paying for health care services for enrollees or quality improvement activities. Due to their exemption from the ACA’s MLR standards, junk plans devoted less than 65 percent of premium revenue to health care services on average in 2017.  This allows for larger administrative budgets for junk plans and more lucrative broker commission payments. Under current rules, consumers do not receive any information about the commissions that their brokers receive for facilitating enrollment in various types of health coverage.

These actions by brokers to promote junk plans are alarming. Not only are junk plans allowed to deny coverage or charge higher premiums based on an individual’s pre-existing condition, but these plans also are not required to cover the ACA’s essential health benefits, including maternity care, substance use disorder treatment and prescription medications. A recent analysis of 24 junk plans across 45 states found that only 29 percent offered prescription drug coverage and none of the plans offered maternity care coverage.  These plans are also allowed to establish arbitrary limits on the dollar value of services that will be covered annually. Junk plans are not subject to the ACA’s rules that cap how much an insurer can require an enrollee to pay out-of-pocket each year for medical care. These junk plans present real risks for consumers that are often masked on web broker internet pages and in phone calls with brokers. 

While federal rules prohibit brokers from displaying junk plans side-by-side with ACA-compliant QHPs, brokers can structure their webpages in ways that steer consumers toward higher-commission products, like junk plans.  ACA-compliant QHPs can often be presented on webpages in tabs adjacent to junk plans, with the premium information for each type of plan displayed in the tab without easily-noticeable information on the important differences in coverage and deductibles between QHPs and junk plans.

Equally concerning, web brokers’ online screening tools can fail to identify instances where a customer is eligible for Medicaid.  In other instances, the screening tools may identify potential Medicaid eligibility, but the web broker platform may continue to push a customer to purchase a junk plan. For example, on the GoHealth web broker platform,  if a customer from Manchester, New Hampshire, enters information indicating a household that is composed of a 31-year old mother and a six-year old son, with total income of $15,000, the web broker provides a pop-up notice indicating that the customer “might qualify” for Medicaid, but does not provide any links or additional information for the customer to use to contact the Medicaid program. Instead, when the customer clicks “Continue” to get rid of the pop-up notice, the customer is presented with ACA-compliant QHPs in one tab with full-cost premiums starting at $274 per month and junk plans in another tab with premiums starting at $112 per month. In this instance, the customer is not provided with readily available information warning about the junk plans’ coverage limits.

For states that have not yet expanded Medicaid, the web broker platforms also fail to consistently identify Medicaid eligibility for children that are part of a family application submitted to the broker portal.  Even in cases where the web broker identifies the child’s eligibility, the broker may still steer the customer to a junk plan for family coverage. For example, on the eHealth online platform, if a 31-year old mother from Milwaukee, Wisconsin, with annual income of $15,000 submits information for coverage for herself and her six-year old son, the eHealth portal provides notification of potential Medicaid eligibility and links for the Wisconsin Medicaid website. However, the eHealth portal also suggests that “While you wait for a decision from your state’s Medicaid authority, a short-term health plan can help bridge coverage gaps.” As a part of this same page, the eHealth portal displays a link for a junk plan with a $68 per month quoted premium and no immediate information about the coverage restrictions associated with the junk plan.  This junk plan  does not cover pre-existing conditions, has a $12,500 annual deductible for each family member and does not cover prescription drugs.

In other instances, web broker internet pages are used predominantly as a “lead generation” tool, where customers fill out contact information and then receive follow-up phone calls from a broker to discuss insurance options. For these cases, “secret shopper” research suggests that broker phone calls often involve “aggressive sales tactics, encouraging consumers to purchase [junk plan] coverage over the phone with minimal plan information.”  Broker phone calls are not recorded for subsequent oversight by CMS or other regulators. These findings further underscore the need to improve oversight of broker-based enrollment through HealthCare.gov website links and related direct enrollment agreements with CMS.

To help address the concerns raised in this letter, we request answers to the following questions:

1. Please explain what protocols or processes, if any, CMS has in place to track whether individuals who access HealthCare.gov and click through to web broker links are ultimately enrolled in a QHP, enrolled in a junk plan, or successfully transferred to a State Medicaid Agency for enrollment in Medicaid. If no such tracking protocols exist, please explain why the agency does not support such tracking and oversight
2. Please explain how CMS intends to ensure that individuals who access web broker platforms and are eligible for Medicaid are provided with comprehensive information about Medicaid eligibility and successfully transferred to the appropriate State Medicaid Agency.
3.  Please explain why CMS has not included contractual requirements with its broker partners to require any disclosure to consumers of commissions that web brokers will receive for facilitating enrollment in various types of plans, including junk plans in particular.

An effective and well-functioning health insurance market is only possible if consumers are provided transparent information regarding the scope and cost of coverage available, the tax credits available to consumers to offset premiums for comprehensive health plans and the incentives that brokers have for selling various products. Availability of this transparent information is particularly critical in light of your agency’s decision to reduce funding for Health Insurance Marketplace  advertising, outreach and education efforts by approximately 90 percent compared to 2016 levels. Your regulatory oversight in this area is vitally important to achieving this effective insurance market. We urge you to take this oversight responsibility seriously.

Sincerely,

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) said today that he was optimistic about the chances of passing bipartisan anti-money laundering legislation this Congress after the House voted yesterday to advance a bill that would curb illicit financial activities by requiring companies to disclose their true beneficial owners, and increasing information-sharing between law enforcement, financial institutions, and the Treasury Department.

Last month, Sen. Warner – along with Sens. Tom Cotton (R-AR), Doug Jones (D-AL), Mike Rounds (R-SD), Bob Menendez (D-NJ), John Kennedy (R-LA), Catherine Cortez Masto (D-NV), and Jerry Moran (R-KS) – introduced the Improving Laundering Laws and Increasing Comprehensive Information Tracking of Criminal Activity in Shell Holdings (ILLICIT CASH) Act, which would, for the first time, require shell companies – often used as fronts for criminal activity – to disclose their true owners to the U.S. Department of Treasury.

“Today’s House vote is an encouraging sign of progress on this important issue, and it demonstrates that there is widespread support in Congress for reforming our laws to combat money laundering, fight crime, and improve our national security,” said Sen. Warner following the House vote. “I appreciate the Treasury Department’s willingness to work with Congress on this matter, and am hopeful that the Senate will soon move forward on our bipartisan proposal to crack down on shell companies, while also prioritizing data security and protecting small businesses from unnecessary regulation.”

According to research from the University of Texas and Brigham Young University, the U.S. remains one of the easiest places in the world to set up an anonymous shell company. A recent report by Global Financial Integrity demonstrates that, in all 50 U.S. states, more information is required to obtain a library card than to register a company. Human traffickers, terrorist groups, arms dealers, transnational criminal organizations, kleptocrats, drug cartels, and rogue regimes have all used U.S.-registered shell companies to hide their identities and facilitate illicit activities. Meanwhile, U.S. intelligence and law enforcement agencies find it increasingly difficult to investigate these illicit financial networks without access to information about the beneficial ownership of corporate entities involved.

The ILLICIT CASH Act would crack down on anonymous shell companies by requiring these companies to disclose their true owners to the U.S. Department of Treasury. It would also update decades-old anti-money laundering (AML) and combating the financing of terrorism (CFT) policies by giving Treasury and law enforcement the tools they need to fight criminal networks. A section-by-section analysis of this bill is available here. A one-pager is available here. The full text of the bill is available here. 

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Josh Hawley (R-MO) and Richard Blumenthal (D-CT) will introduce the Augmenting Compatibility and Competition by Enabling Service Switching (ACCESS) Act, bipartisan legislation that will encourage market-based competition to dominant social media platforms by requiring the largest companies to make user data portable – and their services interoperable – with other platforms, and to allow users to designate a trusted third-party service to manage their privacy and account settings, if they so choose.

“Social media has enormous benefits. But, as we've seen, the tremendous dominance of a handful of large platforms also has major downsides – including few options for consumers who want to use social media to connect with friends, store their photos or just watch cat videos, but who face a marketplace with just a few major players and little in the way of real competition,” said Sen. Warner, a former technology entrepreneur and venture capitalist. “As a former cell phone guy, I saw what a game-changer number portability was for that industry. By making it easier for social media users to easily move their data or to continue to communicate with their friends after switching platforms, startups will be able to compete on equal terms with the biggest social media companies. And empowering trusted custodial companies to step in on behalf of users to better manage their accounts across different platforms will help balance the playing field between consumers and companies. In other words – by enabling portability, interoperability, and delegatability, this bill will help put consumers in the driver’s seat when it comes to how and where they use social media.”

“Your data is your property. Period. Consumers should have the flexibility to choose new online platforms without artificial barriers to entry. This bill creates long-overdue requirements that will boost competition and give consumers the power to move their data from one service to another,” said Sen. Hawley.

“The exclusive dominance of Facebook and Google have crowded out the meaningful competition that is needed to protect online privacy and promote technological innovation. As we learned in the Microsoft antitrust case, interoperability and portability are powerful tools to restrain anti-competitive behaviors and promote innovative new companies. The bipartisan ACCESS Act would empower consumers to finally stand up to Big Tech and move their data to services that respect their rights,” said Sen. Blumenthal.

Online communications platforms have become vital to the economic and social fabric of the nation, but network effects and consumer lock-in have entrenched a select number of companies’ dominance in the digital market and enhanced their control over consumer data. The Augmenting Compatibility and Competition by Enabling Service Switching (ACCESS) Act would increase market competition, encourage innovation, and increase consumer choice by requiring large communications platforms (products or services with over 100 million monthly active users in the U.S.) to:

• Make their services interoperable with competing communications platforms.
• Permit users to easily port their personal data in a structured, commonly used and machine-readable format.
• Allow users to delegate trusted custodial services, which are required to act in a user’s best interests through a strong duty of care, with the task of managing their account settings, content, and online interactions. 

“One very real nightmare scenario for the future of the internet is users facing a meaningless choice among a few fully-integrated silos of technology, and the end of independent innovation and creativity. We all need to prevent that from happening. This legislation could help us take a huge step forward towards a better internet future,” said Chris Riley, Director of Public Policy at the Mozilla Corporation.

“Markets work when consumers have a choice and know what's going on. The ACCESS Act is an important step toward reestablishing this dynamic in the market for tech services. We must get back to the conditions that make markets work: when consumers know what they give a firm and what they get in return; and if they don't like the deal, they can take their business elsewhere. By giving consumers the ability to delegate decisions to organizations working on their behalf, the ACCESS Act gives consumers some hope that they can understand what they are giving up and getting in the opaque world that the tech firms have created. By mandating portability, it also gives them a realistic option of switching to another provider,” said Paul Romer, New York University Professor of Economics and Nobel Prize winner in Economics.

“We’re thrilled to see a concrete legislative proposal to provide interoperability for consumers. Built on a solid foundation of privacy and security protections, interoperability enables users to communicate across networks promoting competition among social media platforms. Interoperability ensures that users benefit from increased competition, and it helps new competitors grow by reaching users that are locked-in to their current provider. Senator Warner’s interoperability bill lays out an excellent, practical framework for making interoperability a reality while preserving a role for states to go even further,” said Charlotte Slaiman, Senior Policy Counsel at Public Knowledge.

“All of us at USV believe in decentralized, emergent, market driven innovation. The shared communications infrastructure of the open Internet and a vibrant competitive market triggered the Cambrian explosion of new Web services we all now enjoy. But today, a small number of companies capitalize on their exclusive control over our data - the data we contribute as we interact with their services - to dominate markets, stifling competition and limiting consumer choice. While this is widely understood, most policy makers propose prescriptive regulation that would only further entrench the dominant platforms. The ACCESS Act targets the specific market failure - exclusive control over consumer data - that has led to the consolidation of market power on the Web. Ensuring that consumers have access to their data is an elegant way to restore competition without burdensome regulation,” said Brad Burnham, Partner and Co-Founder at Union Square Ventures.

Previously, Sens. Warner and Hawley have partnered on the DASHBOARD Act, legislation to require data harvesting companies such as social media platforms to disclose how they are monetizing consumer data, as well as the Do Not Track Act, which would allow users to opt out of non-essential data collection, modeled after the Federal Trade Commission’s (FTC) “Do Not Call” list. 

A section-by-section summary of the bill is available here. Bill text is available here.

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WASHINGTON, D.C. – Today, U.S. Senators Mark R. Warner and Tim Kaine announced $504,450 in federal funding through the U.S. Department of Health and Human Services (HHS) for the Mount Rogers Health District in Southwest Virginia, which oversees eight localities at the epicenter of the addiction crisis. The funding will allow the district to partner with researchers across the country on solutions to address the addiction crisis in Southwest Virginia. 

“The drug addiction crisis has hurt every region of Virginia. We need to invest in more resources to better understand how to prevent and combat substance use disorders,” the Senators said. “This funding will help expand services for families impacted by addiction and support studies that explore how early exposure to substance abuse affects young people.”

The Mount Rogers Health District serves Bland, Carroll, Grayson, Smyth, Washington, and Wythe counties, and the cities of Bristol and Galax. The first round of this project will build capacity at partner sites. The second round will support a ten-year longitudinal study.

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) issued a statement today on the passing of former state Del. Alan A. Diamonstein:

“Alan Diamonstein was a powerful force in Virginia, national politics and his community. He was a major figure in making our Commonwealth a more inclusive, forward-looking and fairer place.

“I was proud to call him an adviser and a mentor, but most importantly – my dear friend.

“I will miss Alan very much, and will be thinking of Beverly and their children during this difficult time.”

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) requested information from Virginia’s insurance commission on how the Trump Administration’s push for “junk” health insurance plans is affecting protections for Virginians with preexisting conditions. The “junk plans,” which are permitted to discriminate against Americans with preexisting conditions such as diabetes, asthma and cancer, are part of the Trump Administration’s overall effort to undermine the success of the Affordable Care Act and eviscerate protections for people with preexisting conditions. Senate Democrats, led by Sen. Warner, will force a vote on the Senate floor before the end of the month to overturn the Trump Administration’s rule on junk plans and protect people with preexisting conditions.

“We have heard concerning reports that individuals nationwide – particularly Americans with preexisting conditions – are unknowingly enrolling in these deceptively marketed junk plans that fail to cover many essential health care services,” wrote the Senators in today’s letter to the State Corporation Commission (SCC). “Just this month, Bloomberg reported Arizona resident David Diaz unknowingly purchased a short-term health plan that did not cover preexisting conditions and placed ambiguous limits on emergency room care and other essential health care services. His family has been left with hundreds of thousands of dollars in medical debt. The Washington Post similarly reported on Jesse Lynn, who purchased a short-term health plan not realizing his back problem would be considered a preexisting condition. Jesse’s insurance company refused to cover his care – forcing his family into bankruptcy. No family should be forced into bankruptcy because of a pre-existing medical condition or obscure coverage limits on care.”

A rule issued by the U.S. Department of Health and Human Services (HHS) under the Trump Administration allows states to ignore federal consumer protections and use taxpayer dollars to subsidize junk insurance plans that cover less and cost more. Additionally, under this rule, states can give insurance companies the green light to discriminate against Americans with preexisting conditions by increasing costs, limiting coverage, or denying coverage altogether.

The Senators continued, “The Patient Protection and Affordable Care Act (ACA) established clear protections to prohibit insurance companies from discriminating against individuals with preexisting conditions and also required insurers to spend a minimum amount of their customer’s premium dollars on medical care. We are concerned the short-term health plans HHS has touted gut these protections and empower insurance companies to deny coverage to individuals with preexisting conditions, place arbitrary coverage limits on essential health care services and charge individuals more for services such as mental health care and maternity care.”

In their letter to SCC Commissioners Mark Christie, Judith Williams Jagdmann, and Patricia West, the Senators cited a study by the National Association of Insurance Commissioners that found that junk plans spend only 39 percent of patient premiums on medical care, whereas insurance plans under the ACA are required to spend at least 80 percent of these premiums on medical care. They also requested answers to the following questions regarding the effect of junk plans on Virginians:

1. How many Virginia residents are currently enrolled in short-term limited-duration insurance plans?
2. Has the Commission received complaints from Virginia residents regarding the marketing practices of such plans? If so, summarize the substance of the complaints and the number of complaints the Commission has received. 
3. How is the Commission working to ensure that individuals obtain quality, comprehensive coverage during the upcoming open enrollment period?
4. Has the Commission taken any enforcement actions against companies that have mislead consumers as to what their plans will cover?
5. How is the Commission collaborating with other states to limit the proliferation of junk plans and ensure that individuals have access to both the necessary information and comprehensive coverage they need?

Sens. Warner and Kaine have long fought against the Trump Administration’s efforts to dismantle our nation’s health care law. Two weeks ago, Sens. Warner and Kaine urged the HHS and the Centers for Medicare & Medicaid Services (CMS) to limit the proliferation of junk plans. Additionally, they introduced a Congressional Review Act resolution led by Sen. Warner earlier this year to stop the Trump Administration from promoting junk plans, and Sen. Warner filed a discharge petition last month that will force the Senate to vote before November 12 on whether to roll back the rule allowing these harmful changes.

The letter text can be found below and a PDF copy is available here.

October 16, 2019

Mark C. Christie                                 

Commissioner                                    

State Corporation Commission          

P.O. Box 1197                                     

Richmond, Virginia 23218      

Judith Williams Jagdmann

Commissioner

State Corporation Commission

P.O. Box 1197

Richmond, Virginia 23218

Patricia L. West

Commissioner

State Corporation Commission

P.O. Box 1197

Richmond, Virginia 23218

Dear Commissioners Christie, Williams Jagdmann and West:

We write to express our concern with recent reports on the expanded use of short-term limited-duration insurance (STLDI) “junk plans” that weaken protections for Americans with preexisting conditions and increase costs for millions more. As you are likely aware, the U.S. Department of Health and Human Services has made a series of recent changes to increase enrollment in short-term health plans. We have heard concerning reports that individuals nationwide – particularly Americans with preexisting conditions – are unknowingly enrolling in these deceptively marketed junk plans that fail to cover many essential health care services.

Just this month, Bloomberg reported Arizona resident David Diaz unknowingly purchased a short-term health plan that did not cover preexisting conditions and placed ambiguous limits on emergency room care and other essential health care services. His family has been left with hundreds of thousands of dollars in medical debt. The Washington Post similarly reported on Jesse Lynn who purchased a short-term health plan not realizing his back problem would be considered a preexisting condition. Jesse’s insurance company refused to cover his care – forcing his family into bankruptcy. No family should be forced into bankruptcy because of a preexisting medical condition or obscure coverage limits on care.

The Patient Protection and Affordable Care Act (ACA) established clear protections to prohibit insurance companies from discriminating against individuals with preexisting conditions and also required insurers to spend a minimum amount of their customer’s premium dollars on medical care. We are concerned the short-term health plans HHS has touted gut these protections and empower insurance companies to deny coverage to individuals with preexisting conditions, place arbitrary coverage limits on essential health care services and charge individuals more for services such as mental health care and maternity care. A recent study released by the National Association of Insurance Commissioners found that such plans spend just 39 percent of patient premiums on medical care. In contrast, insurance plans under the ACA are required to spend at least 80 percent of patient premiums on medical care.

Given the harmful effect these plans are having on families nationwide and broad agreement on their serious shortcomings we would like to gain a better understanding of how these plans are marketed and used in Virginia. To that end we would like to know:

Thank you for your consideration of this letter. We look forward to your responses to these questions and to working with you on this important issue.

Sincerely,

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) announced $375,000 in federal assistance to help advance an initiative in Charlottesville, Va. by the Charlottesville Food Justice Network to expand food access for youth and families, cultivate local food equity, and fuel and sustain economic empowerment through increased community-led urban agriculture. This funding, from the National Institute of Food and Agriculture (NIFA) at the U.S. Department of Agriculture (USDA), was awarded through the Community Food Projects Competitive Grant Program (CFPCGP), a program designed to fight food insecurity by supporting the development of community food projects that promote self-sufficiency for low-income communities.

“With more than 1 million Virginians living in low-income areas with little or no access to healthy foods, it’s clear that food equity remains a critical issue in our Commonwealth,” said the Senators. “We are thrilled to announce that the Charlottesville Food Justice Network will be receiving federal support to build long-lasting solutions to expand food security in Charlottesville.”

Led by Charlottesville Food Justice Network, the Just Food for US (United Society) initiative aims to create an equitable food system through citizen-led urban agriculture, market development, youth leadership, and cross-sectorial action for local food policy. This grant will support a multifaceted effort to employ food insecure adults and youth as food justice leaders, increase racial equity practices in 30+ local food system organizations, and expand resident-led urban food production, distribution, and market participation at 16 urban sites for 50,000 lbs. of produce. The initiative will also develop food policy recommendations and help enact these changes.

Sens. Warner and Kaine have been advocates for providing better resources to low-income, rural and urban communities who have limited or no access to nutritious foods. In March, Sen. Warner introduced the Healthy Food Access for All Americans Act (HFAAA) – legislation to incentivize food service providers like grocers, retailers, and nonprofits to expand access to nutritious foods in underserved communities. Earlier this year, Sens. Warner and Kaine, along with a group of 45 other Senators, urged the Trump administration to rescind a proposed rule that would take away nutrition benefits from Americans struggling to find stable employment.

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