This coming week's In Brief is being sent out early due to Disability Policy Seminar.
On Thursday, the President's "Skinny" budget was transmitted to the Congress. While there are not a lot of details, the President's priorities for the nation are clearly outlined. As previously mentioned in In Brief, the budget increases defense spending by $54 billion by cutting the same amount in non-defense discretionary programs. (What the President's budget fails to mention is that to increase the defense discretionary funding amount Congress would have act to raise the caps included in the Budget Control Act, which would be difficult.)
The Administration highlights "hundreds" of programs it recommends for elimination and reduction in the budget but does not specify all of them. The Budget contains double digit cuts to several priority agencies for people with disabilities. Here are some highlights:
- The budget would cut 18 percent ($15.1 billion) from the Department of Health and Human Services (HHS), the agency that operates the largest number of discretionary programs for people with disabilities. NIH is cut by $5.8 billion to $25.9 billion. NICHD is not mentioned.
- The 13 percent proposed cut for the Department of Education is that largest we have seen for education programs. Despite the level funding proposed for the Individuals with Disabilities Education Act (IDEA), students with disabilities will be adversely affected by significant cuts to community schools, professional development, and class-size funding.
- Housing programs take a nearly identical hit with a 13.2 percent decrease for the Department of Housing and Urban Development, with only about half of the 7.5 billion in proposed cuts identified.
- The Department of Labor, would see a 21 percent decrease, including unspecified cuts to job training and employment service formula grants, projected to results in the loss of over 123,000 supported jobs.
- Eliminates $403 million in health professions and nursing training programs. There is no mention of maternal and child health programs.
- On a positive note, it says it launches an early intervention demonstration project to test methods to help individuals with disabilities remain attached or reconnect to the labor but there are no other details
A more detailed President's budget is expected in May. At that time, we will see program funding levels. Also, remember that this is only the beginning of the process. Congress will have to develop their own Budget Resolution and annual appropriations bills. Nevertheless the Congress will take the President's ideas into consideration as they are developing their budgets, therefore, we must take these cuts seriously. AUCD will be monitoring this process closely.
American Health Care Act (AHCA)
Last week, the Congressional Budget Office's (CBO) analysis of the House bill to repeal the Affordable Care Act, the American Health Care Act (AHCA). The CBO estimates that the AHCA will result in 13 million individuals losing their health insurance in the first year and 24 million over ten years. The CBO estimates the bill cuts federal Medicaid spending by $880 billion over ten years, with 14 million Americans losing the care that Medicaid provides them. The Center on Budget and Policy Priorities explains that the bill effectively ends the Medicaid expansion by making it financially unsustainable for states, which would leave those enrolled unprotected. Furthermore, the bill's per capita cap " would put even more Medicaid enrollees at risk as it would shift costs to states, resulting in large and growing cuts to the overall program over time; this in turn would result in people being placed on, already exhausted, waitlists or losing vital services all together. The Consortium for Citizens with Disabilities (CCD) released a statement in response to the CBO score asserting that the bill would endanger the lives and independence of the more than 10 million people with disabilities who rely on Medicaid. AUCD worked with CCD to develop a week-long action toolkit for grassroots advocates.
Prevention and Public Health Fund
If passed, the American Health Care Act would also eliminate the Prevention and Public Health Fund (PPHF) beginning FY 2019. The CBO estimates that eliminating the PPHF would reduce mandatory spending by $9 billion over the next decade. The ACA established the PPHF to boost public health funding and to support activities that foster public health. Eliminating the fund would likely lead to more spending due to rising costs from increased cases of illness. Vox reports, the move will cripple the Section 317 vaccines program, which ensures that doctors and patients have access to vaccines, and supports the response to disease outbreaks.
On March 8, the Committee on Education and the Workforce, chaired by Representative Virginia Foxx (R-NC), considered legislative proposals that claim to expand health care coverage, lower costs, and promote a healthy workforce. As last week, Preserving Employee Wellness Programs Act (H.R. 1313) passed, which will strip away privacy protections for people enrolled in workplace wellness programs. Currently, an employer's ability to collect and use the health information of their employees is tempered by two privacy laws, the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA). H.R. 1313 removes these protections. CCD sent a letter to the Committee leadership expressing opposition to such a bill. The letter explains that people with disabilities already have employment rates far below those of the general population, and that Congress should be encouraging strategies to increase employment of people with disabilities, not penalizing employees for having disabilities or for choosing to keep their health and genetic information private.
Prevention of Toxins in the Workplace
AUCD signed on to a letter to Jeff Bezos, the CEO of Amazon. The letter requests Amazon address significant concerns about the public health impacts of toxic chemical-intensive products that form part of its supply chain. In addition to causing environmental damage, many of these chemical can cause cancer, reproductive harm and learning and developmental disabilities. The letter calls on Amazon to develop and publicize a comprehensive policy to identify, remove and safely substitute toxic chemicals that exist in certain products and packaging used by the company. They also urge Amazon to report publicly on its implementation of these changes.
Home and Community Based Services
Last Tuesday, Secretary of Health and Human Services (HHS) Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma issued a letter to the nation's governors laying out their vision for Medicaid. In the letter, they indicate a willingness to waive longstanding rules that are designed to protect low-income Americans from coercion, poverty, and exploitation. The letter addresses the opioid epidemic, HCBS settings rule, employment and community engagement, and federal and state program management. AUCD is in the process of reviewing this letter.
Disability Policy Seminar
Over 1,000 are coming to this year's annual DPS this week (March 19-22) (see online schedule). AUCD bookends the DPS with a Trainee Seminar on Sunday, March 19 and an AUCD Employment for All Gala Wednesday night, March 22. Also, Senators Casey has scheduled a press conference to discuss the American Health Care Act and its cuts to Medicaid on March 22 the Senate Lawn at 11am. DPS participants are encouraged to participate if it doesn't interfere with scheduled Hill visits. Those unable to participate in the DPS are encouraged to call or email their Members of Congress regarding the impact of the health care repeal bill and Medicaid caps. See CCD action toolkit for grassroots advocates and the DPS fact sheets for talking points.
Tuesdays with Liz: Disability Policy for All
In this week's edition of Tuesdays with Liz: Disability Policy for All Liz interviews Donna Meltzer (Executive Director of the National Association of Councils on Developmental Disabilities) for the second part of how the President's budget is implemented. In case you missed last week's episode, Liz interviewed Donna Meltzer for the first part of the President's budget - explaining the difference between a personal budget and the government's budget.
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For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms