2018 CANDIDATE PROGRAM Steven Horsford (D-NV-04) Current Seat Holder Ruben Kihuen (D) Seat Status Leans D Born in Las Vegas, Nevada, Steven Horsford served District 4 from 2013 to 2015 before losing reelection to Cresent Hardy. After losing the 2014 election, Horsford became an executive at R&R Partners, a business consulting firm. Horsford served in the Nevada Senate Biographical Sketch from 2005 to 2012 and served as Senate Majority Leader in 2008. He was the National Vice Chairman of the Democratic Legislative Campaign Committee, as well as the Committeeman for Nevada during the 2012 Democratic National Convention. He is married to Dr. Sonya Horsford and they have three children. Receipts: $250,060.39 Individual: $144,360.39 Disbursements: $60,062.37 FEC Filing as of PAC: $103,200.00 Cash on Hand: $189,998.02 5/21/2018 Party: Debt: $28,753.47 Candidate: $2,500.00 Other: Polling Endorsements 1. Healthcare 4. Veterans Top Campaign Issues 2. Gun Control 5. Small Business 3. Jobs Recently, Horsford was quoted saying “I’m a supporter of the need to provide health care for all Role of Healthcare Americans. There are many policies and approaches that will accomplish that. Medicare for All is a in the Campaign viable proposal but it does have its shortcomings.” Located in the central portion of the state, Nevada’s 4th Congressional District includes most of northern Clark County, southern Lyon County, and all of Esmeralda, Lincoln, Mineral, Nye, and District Profile White Pine counties. 2016 Presidential Vote: Clinton 50%, Trump 45% Cook’s Partisan Voter Index: 2016 Congressional Vote: Kihuen 48%, Hardy 44% D+3 Campaign Manager Detrick Sanford Contact Information [email protected] Social Media https://www.facebook.com/stevenhorsford/ https://www.stevenhorsford.com/ Updated 5/21/18 Candidate profiles, including race projections, are updated quarterly until August 1 and monthly thereafter. The latest HLC race projections are available on the HLC Candidate Program website under “Open Seats” and “Other Races to Watch” respectively. All posted information has been provided by the HLC Regional Director and various sources including National Journal, The Cook Political Report, the Federal Election Committee, the candidate’s website, etc. and not directly provided by the candidate. For more information contact HLC Regional Director Paul Pearson– Phone: 405-488-0541– Email: [email protected] 2018 CANDIDATE PROGRAM QUESTIONNAIRE Steven Horsford (D/NV04) This report is designed as a tool to aid the interview and meeting process. It is not meant to be filled out by the candidate or candidate’s staff, nor even shown to them. These questions are meant to guide the conversation. At the conclusion of the meeting, the HLC Regional Director completes the report based on the interview and other available information. Candidate: Incumbent: As of: Steven Horsford Ruben Kihuen (D) 08/01/2018 Executive Summary & Overall Rating Educated on healthcare issues? YES NO Looking for HLC’s help to learn healthcare issues? YES NO Supportive of HLC’s agenda overall? YES NO Elected official or other government background? YES NO If so, what? Former State Senator and U.S. Congressman Has a healthcare background? YES NO If so, what? ______________________________________ OVERALL HEALTHCARE PHILOSOPHY Former Congressman Steven Horsford says that healthcare is the number one issue in his district. He is a supporter of the Affordable Care Act but understands that the exchanges need to be strengthened and other significant changes need to be made to stabilize the market. While a state senator, he successfully advocated for the expansion of Medicaid. His basic healthcare philosophy is in line with HLC’s market-based approach. Though he wants universal coverage, he does not support the Medicare For All effort. During his one term in Congress, he joined the Progressive Caucus but says he is more in line with the moderate New Dem Caucus. He is concerned about rural healthcare delivery, keeping drug costs affordable, interoperability of medical record systems, keeping coverage for the 23,000 constituents with pre-existing conditions and finding workable solutions to access. POSITION AND KNOWLEDGE OF SPECIFIC POLICIES (based on the 2018 HLC Strategic Plan) 5 4 3 2 1 Strongly Supports Strongly Opposes Generally Supports Generally Opposes HLC Agenda Mixed Support HLC Agenda HLC Agenda HLC Agenda (Agrees) (Disagrees) TOTAL SCORE: Percent Agreement with HLC Positions noted below 96% 5 Quality healthcare must be accessible and affordable for all Americans. 5 Healthcare policy must create an environment in which innovation is encouraged to thrive. 5 We must ensure Medicare and Medicaid are available for future generations. 4 The private sector plays an essential role in the delivery of healthcare. 5 The Opioid crisis requires a collaborative public-private approach with multi-faceted solutions. 1 Below: If a candidate’s position on a specific item is known it will be noted with an S=support; O=Opposes or left blank if not known Quality Healthcare Must Be Accessible and Affordable for All Americans 1. The federal government should support the private sector to establish systemwide health S information interoperability by 2019. 2. Data-related policies should also continue to improve patient and health entity access to federally S held health information. 3. The government should prohibit data blocking. 4. Various patient privacy laws and regulations should be harmonized, because the current S patchwork of state laws and regulations on patient confidentiality are not well suited for a healthcare system that is increasingly interstate in nature. 5. Congress needs to continue to strengthen security against cyber attacks without adding new S layers of burdensome and duplicative bureaucracy to the existing regulatory structure 6. Medicaid “best price” policies discourage innovative pricing approaches and must be modernized. S 7. Stark physician self-referral and antikickback regulations need to be modernized if healthcare is to become truly integrated and patient-centered. 8. The U.S. Food and Drug Administration approval process for drugs and devices needs to continue S to be streamlined. FDA should not expand their purview to other areas, such as laboratory developed tests, which could delay patient access to lifesaving treatments. 9. Barriers that prevent companies in different healthcare sectors from sharing efficacy and S economic information about particular products prior to FDA approval must be removed. 10. The government must support innovative approaches to assist high-need populations (e.g., S integrated care models, independence at home projects and focus on social determinants of health.) 11. Providing “safe harbors” from litigation to healthcare providers who can show they have utilized S accepted standards of care in treating their patients will reduce the practice of defensive medicine, lower costs and improve patient outcomes. 2 Healthcare Policy Must Create an Environment in which Innovation is Encouraged to Thrive 12. Health plans participating in the Health Insurance Marketplace should be afforded greater S flexibility in making affordable, high quality coverage accessible to consumers, including using traditional risk adjustment models. 13 Excessive taxes and payment cuts on various healthcare sectors (e.g., health insurance tax, medical de S and provider cuts) negatively impact patient access to care and health innovation. 14. Additional governmental support for graduate medical education and residency training S positions is needed to address patient demand. 15. The federal government should encourage expanded use of telemedicine and remote patient S monitoring to improve access to coordinated care. 16. The value of healthcare interventions and services should be considered across the healthcare S continuum and must include the patient perspective. We Must Ensure Medicare and Medicaid are Available for Future Generations 17. The best way to achieve the lowest prices for Medicare beneficiaries in the Medicare Part D S program is through the current process of private sector negotiation. 18. The Medicare Advantage Program utilizes consumer choice and market competition to S strengthen program value and sustainability and should be supported. 19. The Independent Payment Advisory Board (IPAB) is likely to impose arbitrary, across-the-board reductions for Medicare providers, which would reduce access to quality care for Medicare beneficiaries. 20. The federal government should ensure payment and delivery structures encourage care S coordination and alignment between acute care, post-acute care, and community health and address chronic disease. 21. CMS, through the Center for Medicare and Medicaid Innovation, should test new payment and delivery concepts that can improve care while containing cost growth. 22. The Medicaid program should be structured in a way that encourages construction of innovative S state Medicaid programs that emphasize improved health outcomes and better efficiency. Version 1 3 .