Disability Policy News In Brief

August 22, 2016

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August 22, 2016   |   Vol. XV, Issue 86
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Budget/Appropriations

When Congress returns in from recess next week, they will have very little time to finalize the 12 annual appropriations bills before the fiscal year ends on September 30.  That means Congress will most likely pass a Continuing Resolution (CR) to extend funding at current levels.  It is not yet clear how long the CR would last.  Some Members recommend passing a short-term CR so that Congress can put together an omnibus spending bill in the lame duck session (November - December).  Others want a CR to extend into March, so that the new Congress and Administration can make the decisions.  We know that stop-gap spending measures are hard on many programs.  It may make it hard to plan for a full year, or respond well to changing needs.  Please share with AUCD staff the impact recent cuts and continued flat-funding is or may have on your Center, program, or initiatives so that we can help appropriators understand the impact of not taking action on appropriations bills. Send your stories to kmusheno@aucd.org.

Civil Rights

On August 11, the Department of Justice (Department) issued a final rule to incorporate the statutory changes to the Americans with Disabilities Act (ADA) set forth in the ADA Amendments Act of 2008, which took effect on January 1, 2009. In response to earlier Supreme Court decisions that significantly narrowed the application of the definition of "disability" under the ADA, Congress enacted this law to restore the understanding that the definition of "disability" was intended to be broadly construed and applied without extensive analysis. Congress intended that the primary object of attention in cases brought under the ADA should be whether covered entities have complied with their statutory obligations, not to discriminate based on disability. In this final rule, the Department is adding new sections to its title II and title III ADA regulations to set forth the proper meaning and interpretation of the definition of "disability" and to make related changes required by the ADA Amendments Act in other sections of the regulations. 

Health Care

Durable Medical Equipment

The CCD Health Task Force, of which AUCD is member, has signed on to a letter addressed to the Centers for Medicare and Medicaid Service's expressing concern for the serious and persistent obstacle to obtaining Durable Medical Equipment (DME) among people with both Medicaid and Medicare benefits in many states. The letter highlights the logistical problems created by the misalignment of Medicare and Medicaid processing rules that lead to barriers in accessing needed care that individuals solely on either Medicaid or Medicare do not have. Often, these problems arise when beneficiaries transition from Medicaid-only status to dual Medicare-Medicaid status. In these instances, individuals who previously had no difficulty obtaining their DME through Medicaid may face vendors who refuse to deliver the same DME once they also become eligible for Medicare because they are concerned that they will not receive payment from either Medicare or Medicaid. 

BENES Act

AUCD signed on to a letter initiated by the Medicare Rights Center supporting the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (H.R. 5772). The BENES Act offers solutions to modernize and simplify Medicare Part B enrollment. Through bipartisan, low-cost reforms, the BENES Act shields Medicare beneficiaries from steep premium penalties, fills gaps in coverage, and provides relief to those who mistakenly delay or decline Part B. The BENES Act requires that a clear and detailed notice explaining Part B enrollment rules be mailed to all individuals aging into Medicare and those nearing eligibility because they receive Social Security disability benefits.

Program of All-inclusive Care for the Elderly (PACE)

The PACE Innovation Act of 2015 provides the Centers for Medicare and Medicaid Innovation (CMMI) the authority to develop PACE pilots for new populations. In anticipation of the pilots, a number of disability community stakeholders have completed work on the Adapted PACE Protocol, which builds on the current PACE program design and adapts it to address the needs and concerns of younger people with disabilities. A webinar is being held on August 24th to discuss the potential pilot populations being served under the PACE Innovation Act of 2015, the Adapted PACE Protocol, and next steps. Register here

RAISE Act

AUCD signed onto a letter in support of the Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act. The letter was sent to Chairman John Kline (R-MN) and Ranking Member Bobby Scott (D-VA) of the House Health, Education and Workforce Committee, as well as Speaker Paul Ryan (R-WI), House Majority Leader Kevin McCarthy (R-CA), House Minority Leader Nancy Pelosi (D-CA), and House Minority Whip Steny Hoyer (D-MD). The RAISE Act would put into effect the federal Commission on Long-Term Care's recommendation that Congress authorize the creation of a national strategy to support family caregivers. The legislation would also create an advisory body that would determine what roles different actors in the public and private sectors could play in providing support to family caregivers. Watch for an action alert from AUCD later today.                                       

ACA

In last week's edition of In Brief, we reported on newly released data from the Centers of Medicare and Medicaid Services indicating that per-enrollee medical costs in the ACA individual market were essentially unchanged in 2015, even as costs in the broader insurance market continued to rise. The data also showed significant reductions in per-enrollee medical costs, and suggests a year-over-year improvement in the ACA individual risk pool, with the Marketplace gaining healthier, lower-cost consumers as it grew. A reason for this is because the ACA created guidelines that encourage people to purchase insurance before they get sick (i.e. by limiting open enrollment periods, imposing a penalty for not have insurance coverage, and providing subsidies to help with the cost of insurance).

class="normal">Following the release of this information, there has been news of a major insurer (Aetna) withdrawing from the marketplace. Despite the improvements in health among consumers as well as reduced cost to insurance companies, Aetna plans to reduce their options from 778 counties in 15 states to 242 counties in four states. This decision could be due in part to loss in profit as claimed by Aetna or, as some claim, it may be related to a failed merger with Humana (see NYT report).  Though Aetna claimed "it may re-enter the markets in the future", there is no clear timeline of when this would happen.  Find out more about the different types of Marketplace options here and number of insurers per state here.

 

The next ACA open enrollment period begins November 1. 

                                                            

Employment

On Friday, August 19, the U.S. Departments of Education and Labor announced the publication in the Federal Register of the following final rules implementing the Workforce Innovation and Opportunity Act (WIOA):

The final rules, along with several guidance documents, are available at the RSA WIOA Home Page.

Tuesdays with Liz: Disability Policy for All          

During this week's edition of Tuesdays with Liz: Disability Policy for All, Liz interviews Melody Stevens from the Centers for Disease Control and Prevention on the current state of Zika. In case you missed last week's edition, Liz interviewed Shannon Haworth (AUCDs Public Health Program Manager) about the Public Health Workforce Competencies.


 

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

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

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

 

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