Disability Policy News In Brief

March 23, 2015

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March 23, 2015   |   Vol. XV, Issue 12
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Congressional Schedule

Both Houses are in session.  A large part of floor time is expected to be devoted to the House and Senate budget resolutions. The House and Senate will also work on a bill to permanently replace the physician payment formula in Medicare, a fix for which must be done by March 31. The House and Senate will be in recess for the next two weeks for the Easter and Passover holidays.

Budget

Last week, the House and Senate Budget Committees released their respective budget resolutions. The budget resolution is not a law, but a joint resolution of Congress that sets a blueprint and spending plan for the coming year. It often includes policy recommendations and sets a policy agenda for the party in power. Both budgets fully repeal the Affordable Care Act (ACA).

The House budget, released by Budget Committee Chairman Tom Price (R-GA), sets topline discretionary spending for FY16 at 1.107 trillion (while adding about $90 billion more for defense).  Of the more than $5.5 trillion in cuts over 10 years, $4.2 trillion comes from repealing the Affordable Care Act (ACA) and cuts to mandatory spending. The proposal would convert Medicaid financing to a block grant (rather than the current federal match system) and fold the Children's Health Insurance Program into Medicaid, reducing funding by $913 billion over ten years. The block-grant program would be called State Flexibility Funds and remove many of the federal rules that protect beneficiaries. The budget also revives a proposal to privatize Medicare by providing "premium support" vouchers for Medicare beneficiaries to purchase private health insurance claiming to save $150 billion. The Supplemental Nutrition Assistance Program (SNAP) would also be turned into block grants. 

The Senate budget, released by Budget Committee Chairman Mike Enzi (R-WY) sets topline discretionary spending for FY16 at $1.081 trillion and cuts $4.5 trillion over ten by repealing the ACA and cutting mandatory programs. The Senate resolution requires $600 billion in cuts through "reform of welfare programs." It also envisions additional savings through Medicaid and while it doesn't specifically call for a block grant of it calls for converting Medicaid to a model similar to the Children's Health Insurance Program (CHIP) which is a block grant.

Both resolutions were passed out of their respective committees on Thursday on party-line votes and are expected to be approved by their respective chambers this week. House and Senate Budget Chairs announced they hope to have a budget agreement by April 15th.  If a joint budget passes, the Appropriations Committees will receive an allocation and begin working on their respective spending bills for Fiscal Year 2016 which begins on October 1.

AUCD and CCD are strongly opposed to these proposals. "The programs that would be cut by Chairman Price's budget make up the safety net for people with disabilities," said Katy Neas, CCD Chair, in a statement. "CCD urges Congress to reject the budget and work across the political aisle on solutions that will strengthen our national economy." Learn more about the potential negative impact on children and adults with disabilities from the Georgetown Center for Children and Families and Center on Budget and Policy Priorities and watch action alerts on this issue.

Health

Today marks the 5th anniversary of the Affordable Care Act! Learn more about what the law has done in the last five years from the White House blog, briefing room, and YouTube channel.

Bipartisan House leaders last week released their plan to address a looming problem in physician payments in Medicare. Legislation to address the Sustainable Growth Rate (SGR) or "doc fix" has been passed regularly for almost a decade. Last year, bipartisan bicameral Members of Congress created an agreement to replace the much-maligned physician payment schedule with a system focused on patient health and value-based payments. See March 24, 2014 In Brief for more information on last year's deal. This new bill would build upon last year's agreement. It would also extend the Children's Health Insurance Program (CHIP) for two years. AUCD is working with the disability community to ensure that important "extender" policies that usually ride with SGR are also made permanent, including a fix to therapy payments in Medicare, funding for Family-to-Family Health Information Centers and the Maternal, Infant, and Early Childhood Home Visiting Program. Last year, the bill did not pass because negotiators could not come to agreement on offsets for the cost of the legislation. Offset proposals have not been released.

The Equal Employment Opportunity Commission (EEOC) will release a proposed rule regarding the Americans with Disabilities Act and protections for workers with disabilities in workplace wellness programs that include financial incentives. ADA enforcement by the EEOC has recently been under scrutiny from Congress. The Education and the Workforce Committee will hold a hearing tomorrow on bills to "Provide Greater EEOC Transparency, Accountability." AUCD signed on to a letter to the committee opposing the proposed bills and supporting ADA and Genetic Information Non-Discrimination Act provisions that protect workers from disclosing medical conditions that are unrelated to their ability to do their jobs. AUCD will work with CCD and the disability community to support these protections for workers with disabilities in both legislation and regulation.

FY 2016 Appropriations

AUCD joined other "Friends of HRSA" in a letter to House and Senate appropriations leaders urging them to support $7.48 billion in discretionary funding for Health Resources and Services Administration programs, including the LEND program, in the FY 2016 Labor, Health and Human Services, Education, and Related Agencies appropriations bill. The Friends of HRSA is a coalition of 170 national organizations, including AUCD, dedicated to improving health through supporting a well-prepared workforce and the delivery of quality health services.  Members of the coalition, including AUCD, also met with members of the Appropriations Committees over the past two weeks to educate them about programs within HRSA.

AUCD joined over 200 other organizations in a letter prepared by Trust for America's Health to congressional appropriators urging support for, and allocation of, the Prevention and Public Health Fund in the Fiscal Year 2016 Labor, Health and Human Services, and Education and Related Agencies funding bill.  The Prevention Fund is intended to ensure a coordinated, comprehensive, sustainable, and accountable approach to improving our country's health outcomes through the most effective prevention and public health programs. For example, the Fund has been instrumental in maintaining and increasing support for evidenced-based chronic disease programs funded by Centers for Disease Control and Prevention (CDC). Since 2010, the Fund has provided $5.25 billion to support state and local public health efforts.

Employment

The Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities, created by the Workforce Innovation and Opportunity Act, will hold its second meeting today and tomorrow March 23 & 24.  Today the Committee will hear from a panel on mental health services, review the program/ receive updates on recent CMS guidance, meet in the subcommittees established in the first meeting and report out to the committee, and review FLSA 14 (c) program.  The second day will cover a cross systems state perspective of a successful model being used to increase competitive employment opportunities for individuals with disabilities.  The committee will also be discussing education through an overview of transition with a focus on IDEA transitioning from K-12 to postsecondary education and employment. David Mank, Director of the Indiana UCEDD, chairs the committee.

Tuesdays with Liz: Disability Policy for All

Tomorrow, AUCD will release this week's episode of Tuesdays with Liz, where Liz interviews Taryn Williams, Associate Director in the Office of Public Engagement.  Taryn Williams serves as the White House's liaison to the disability community. The interview covers a variety of topics including the Curb Cuts to the Middle Class initiative, access to post-secondary education, and the upcoming anniversary of the Americans with Disabilities Act.  Subscribe to Tuesdays with Liz: Disability Policy for All and never miss Liz's weekly policy updates and other interviews from high-level disability advocates and policymakers. 

Disability Policy Seminar

We hope you have registered by now to participate in this year's Disability Policy Seminar! The deadline to register has passed but you can still register onsite.  The most important day of the event is Wednesday, April 15, for Hill visits.  Please follow the instructions on how to make Hill visit appointments and be sure to do this before you arrive.   If you need assistance, contact Kim Musheno at kmusheno@aucd.org.


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For updates from our Executive Director Andy Imparato, follow @AndyAUCD.

For more policy news, follow Kim and Rachel on Twitter at @kmusheno and @racheljpat

For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms 

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