Volume 15, Issue 13
March 29, 2010
Major Events Last Week
Health Care Reform
- Increasing Medicaid reimbursement for primary care physicians and pediatricians to Medicare rates for 2013 and 2014;
- Providing increased federal financial support to states to assist in the Medicaid eligibility expansion;
- Increasing affordability subsidies for the new Insurance Exchange;
- Changing the effective date of the Community First Choice Medicaid Option to October 1, 2011.
Since the Senate adopted minor technical amendments to the education (student loans) provisions of the legislation, the bill was sent back to the House, where the amended bill was adopted by a party line margin.
National Commission on Fiscal Responsibility and Reform
Speaker of the House Nancy Pelosi (D-CA) appointed the final three members of President Obama's National Commission on Fiscal Responsibility and Reform. The Speaker appointed Representatives
John Spratt (D-SC),
Xavier Becerra (D-CA), and
Jan Schakowsky (D-IL). The commission is designed to work in a bipartisan way to propose steps to address the nation's long-term debt, bring down the deficit, and ensure that the federal government returns to fiscal discipline. Advocates will be monitoring the Commission's work closely and participating where possible since the large Social Security, Medicare, and Medicaid programs will be part of the commission's focus. It is unclear when the Commission will actually begin meeting.
Obama Administration
On March 27th President Obama announced his intent during the Congressional recess to appoint 15 nominees to fill administration positions. Of particular interest to the disability community are the Equal Employment Opportunity Commission nominees, Chai R. Feldblum, a nationally recognized expert on the ADA, to be a Commissioner, Jacqueline A. Berrien, Nominee for Chair of the EEOC, Victoria A. Lipnic, Nominee for Commissioner, and P. David Lopez, Nominee for General Counsel. Recess appointments means that the person can assume the position but they have not been confirmed by the Senate and their appointment will expire at the end of the Congress unless the Senate acts on their confirmation.
A "hold" was placed on President Obama's nomination of Ari Ne'eman to the National Council on Disability (NCD). Mr. Ne'eman, founder of the
Autistic Self-Advocacy Network, would be the first person with autism to serve on the NCD. The President's other seven nominees to the NCD have been confirmed. Senate rules allow one or more members to anonymously place a "hold" on an action, preventing it from going to the floor for a vote. The reason for the "hold" and what might get it lifted are not clear.
Major Events Ahead
U.S. Congress
The Congress begins a two week recess today. Upon its return on April 12, the Congress will face a critical seven week session prior to the Memorial Day recess. Few bills that have not markedly advanced during the spring will not likely move to passage. Key bills expected to move are the FY 2011 Budget and Appropriations, the Medicaid FMAP extension, jobs bills and the reauthorization of the Elementary and Secondary Education Act (better known as No Child Left Behind).
Health Care Reform
Tomorrow, President Obama will sign the Health Care and Education Reconciliation Act (H.R. 4872) into law in a ceremony at Northern Virginia Community College. The Administration is now beginning the work of implementation of the various provisions of the health care law. The DPC will work closely with other advocates and with the Administration on ensuring that implementation of this important new law will work well for people with disabilities and their families. Republicans have already launched a repeal and replace effort.
With enactment of this second of two pieces of legislation, the final health care reform law marks the attainment of several of The Arc and UCP's priority public policy goals. People with intellectual and developmental disabilities will benefit greatly from the following provisions of the law:
Coverage
- Prohibiting private health insurance exclusions for pre-existing conditions.
- Eliminating annual and lifetime caps in private insurance policies.
- Restricting the consideration of health status in setting premiums.
- Expanding Medicaid to cover individuals with incomes up to 133 percent of the federal poverty line (approximately $29,000 per year for a family of four).
Benefits
- Ensuring that minimum covered benefits include products and services that enable people with disabilities to maintain and improve function, such as rehabilitation and habilitation services and devices.
Access to Quality Care
- Improving training of physicians, dentists, and allied health professionals on how to treat persons with disabilities.
- Requiring the Centers for Medicare and Medicaid Services to collect data on beneficiaries with disabilities access to primary care services and the level to which primary care service providers have been trained on disability issues. Ensuring prevention programs include a focus on individuals with disabilities.
Long Term Services and Supports
Strengthening long-term services and supports through a two pronged approach:
- Taking pressure off of the Medicaid program: The Community Living Assistance Services and Supports (CLASS) Act will create a national long term services insurance program which assists eligible individuals and their families to meet long term needs with a cash benefit and without forcing them into poverty to receive Medicaid benefits.
- Improving the Medicaid program:
- The Community First Choice Option will help to eliminate the institutional bias by encouraging states to cover personal attendant services under the state's optional service plan instead of through the waiver system by offering a 6% increase in the federal share of Medicaid for these services.
- Increasing the federal share of Medicaid for under-performing states trying to rebalance their Medicaid plans to increase the use of home and community based services (HCBS).
- Allowing states to offer additional services under the 1915(i) Medicaid HCBS Waivers State Plan Option.
- Providing spousal impoverishment protections for HCBS Beneficiaries.
Announcements
Disability Policy Seminar
Come to this year's Seminar and learn from national experts about what health care reform will really mean for people with disabilities. With only 2 weeks to go until the start of this year's Seminar, We have nearly 500 registrants from 47 states and the District of Columbia. Don't miss this opportunity to advance our legislative agenda on Capitol Hill. Register today at:
http://www.disabilitypolicyseminar.org/.
Please note that you can view previous issues of the
Capitol Insider, at UCP.org anytime by choosing "Capitol Insider" under "Public Policy."