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Budget
The House Budget Committee is scheduled to release its 2018 budget resolution this week. . Budget Committee Chairwoman Diane Black (R-TN) plans to use the "reconciliation" procedure to cut roughly $200 billion over ten years in entitlement (mandatory) programs. A large share of those cuts likely will come from programs that provide basic assistance to families with low or modest incomes. Chairwoman Black stated, "I'm insisting that we do it in mandatory spending because it is the greatest driver of our debt." The Center on Budget and Policy Priorities (CBPP) reports that this statement is highly misleading for a number of reasons: House Republicans do not intend to cut all entitlement programs equally; House Republicans plan far deeper entitlement cuts than the $200 billion being discussed; Tax cuts, not just spending, contribute to rising deficits and debt; Branding all mandatory spending as the "greatest driver of our debt" ignores important distinctions among programs and obscures the causes of our fiscal challenges.
Appropriations
On July 12, the House Appropriations Subcommittee on Labor, Health and Human Services and Education (L-HHS-ED) released its draft funding bill fund. In total, the bill includes $156 billion in discretionary funding, which is a reduction of $5 billion below the FY 2017 enacted level. The full Appropriations Committee is tentatively scheduled to markup the bill this Wednesday, July 19. While the text of the bill does not contain many details, AUCD sent a preliminary summary regarding known details to the network. The House Subcommittee bill summary highlights its priorities on the committee website. The good news is that the House bill continues funding for HRSA Autism CARES Act programs, including the LEND programs. UCEDD, DD Councils, and P&A programs are level funded compared to the fiscal year 2017 level. The Programs of National Significance are cut by $2.4 billion. For the full AUCD summary, contact Kim Musheno.
The full Committee is scheduled to mark-up the bill this Wednesday, July 19. House leadership is trying to wrap all 12 funding bills together into an omnibus bill and passing it before the beginning of the recess that begins in mid-August. It is unclear if the full committee has the support it needs to pass the bill.
Health Care
Better Care Reconciliation Act (BCRA) Vote Delay
As of Saturday, July 15, Senate Majority Leader Mitch McConnell (R-KY) pushed back the vote on the revised BCRA after Senator John McCain (R-AZ) announced he would be out due to surgery. McConnell gave no new timetable for the vote, saying only that the Senate will "defer consideration" of the bill while "working on other matters." In addition, the Congressional Budget Office (CBO) announced it would delay its analysis of the revised bill, which will include the impact of Senator Ted Cruz's amendment before releasing its overall report.
The revised bill would still have devastating consequences for everyone, but especially for those with disabilities and other pre-existing conditions and anyone who depends on Medicaid for health, education, transportation, or other long term services and supports. The bill still contains provisions to deconstruct, cap, and cut Medicaid by billions; it still allows for waivers to eliminate essential health care benefits and to disregard the prohibition to discriminate against pre-existing conditions; it still eliminates the incentive to provide optional Home and Community Based Services and Supports; and it now contains a section that will create two risk pools (Cruz-Lee amendment)-one that will segregate high health care need individuals from those with lower needs. If these cuts are enacted into law, they will be very difficult to undo as such, please continue to educate your members of Congress about the negative impact of this bill for all Americans, especially those with disabilities and other pre-existing conditions. (See also Center on Budget and Policy Priorities report examining the effects of the Cruz amendment.) President Trump is expected to host a group of senators at the White House today to discuss the bill. Majority Leader McConnell has expressed confidence that he has the votes to pass the bill. AUCD continues to educate Members of Congress about the negative impact this bill would have and to urge Congress to work together on a new bill that would provide accessible, comprehensive, affordable health coverage.
AMCHP
The Association of Maternal & Child Health Programs (AMCHP) released a new report that explores how state agencies dedicated to serving children and youth with special health care needs (CYSHCN) carry out their mission and how their leaders believe they can improve their systems of care. Based on a survey of state and territorial agencies that provide services with federal Title V funding, the National Title V Children and Youth with Special Health Care Needs Program Profile offers insight into the structure and strengths of CYSHCN programs, the roles they play in systems of care, their partnerships, financing of care, and emerging issues.
Managed Care
On June 30, the Centers for Medicare & Medicaid Services (CMS) posted an update on Medicaid Managed Care Regulations compliance dates. CMS' Medicaid managed care final rule includes several provisions that have a compliance date beginning with the rating period for managed care contracts that start on or after July 1. States are required to comply with these provisions; however, as states have noted, there can be administrative challenges associated with updating states' managed care contracts and operational procedures. As a means to remedy these challenges, states will need to identify for CMS those regulations of the final rule that they are unable to implement by the required compliance date in order for CMS to work with states on assessing compliance with the specific regulation (indicated in this memo); however, CMS is unable to permit flexibility for all provisions of the final rule for which compliance is required for contracts beginning on or after July 1 (also noted in this memo).
Education
The House Education and the Workforce Committee will hold a hearing tomorrow, July 18 on state and local efforts to implement the Every Student Succeeds Act (ESSA). The hearing comes as the Education Department delivers initial feedback to states on the plans they are required to submit under ESSA that address issues such as how student performance will be measured for accountability purposes. The department has faced criticism for what some see as a narrow reading of the law by the Department in the feedback of the nine plans that have been made public so far. Jason Botel, acting assistant secretary for Elementary and Secondary Education, told Politico last week that the agency is committed to consistency in its feedback to states and is reading each plan to ensure it "gels with federal law". The hearing and witness list can be found here.
Improving Access to Higher Education Act
On July 12, Representative Mark DeSaulnier (D-CA) joined Ranking Member Bobby Scott (D-VA), Subcommittee on Higher Education and Workforce Development Ranking Member Susan Davis (D-CA), Democratic Whip Steny Hoyer (D-MD), and Representatives James Langevin (D-RI) and Jared Huffman (D-CA) to introduce the Improving Access to Higher Education Act. This bill would amend the Higher Education Act (HEA) to improve college access and completion for students with disabilities. This legislation is part of House Democrats' "#AimHigher" initiative, wanting every American to have access to a meaningful degree that leads to a good-paying job. This is the first-ever comprehensive legislation that specifically addresses the needs of students with disabilities in higher education. See here bill text, fact sheet, and a section-by-section. AUCD provided comments on the bill before introduction and sent a letter in support of the bill. Rep. Scott also held a hearing on the bill that was video-taped via Face Book.
Social Security
On July 13, the Social Security Trustees released their 2017 report. The 2017 report continues to report that Social Security overall can pay full scheduled benefits through 2034 - and thereafter will be able to pay roughly 77 percent of promised benefits, absent Congressional action, about the same as last year.
Notably, the 2017 report projects that on its own, Social Security's Disability Insurance fund can pay full scheduled benefits until some point in 2028 - 5 years more than last year's projections. The report attributes this change in projections primarily to lower recent incidence rates (fewer people applying for and being approved for SSDI benefits) and a more gradual rise to higher incidence rates over the long term. The Ways & Means Social Security Subcommittee will held a hearing on the report July 14, which is available here. The CCD Social Security Task Force prepared talking points and a statement on the report available on the CCD website.
Civil Rights
Disability Integration Act
Sources indicate Senator Duckworth (D-IL) plans to cosponsor the Disability Integration Act (DIA). DIA (S.910, H.R.2472) is civil rights bill, introduced by Senator Schumer (D-NY) and Representative Sensenbrenner (R-WI) in the House, to address the bias toward mandatory funding for institutional care rather than having a right to community based care. AUCD, along with over 100 other disability groups are in support this legislation.
Tuesdays with Liz: Disability Policy for All
In this week's edition of Tuesdays with Liz: Disability Policy for All, Liz interviews Wanda Felty, family faculty at the Oklahoma's LEND, about why family support and LEND are so important and how they relate to Medicaid. In case you missed last week's edition, Liz interviewed Sara Van Geertruyden about the importance of Person-Centered Care and research.
For more from AUCD, follow @AUCDNews and like AUCD on Facebook
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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