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Congressional Schedule
The Lame Duck session was originally scheduled to adjourn this week; however, the drama related to the "fiscal cliff" continues with Republican and Democratic leaders continuing to negotiate over the best way to reduce the deficit. The outcome of these debates could profoundly impact funding for programs important to people with disabilities and families. While budget negotiations will dominate the attention of Congress, the House and Senate will also be selecting conferees to work out differences on the National Defense Authorization bill that has consequences for health care for military families with children with disabilities. There are also rumors that at least some of the FY 2013 annual funding bills could be completed before the end of the 112th Congress.
The Disability Treaty
In a sad turn of events last Tuesday, Dec. 4, by a vote of 61-38 (five votes short), the Senate rejected ratification of the Convention on the Rights of Persons with Disabilities (CRPD). Just the week before, advocates had thought they had the two-thirds votes necessary for ratification. Unfortunately, several Republican Senators who had previously committed to supporting the treaty caved to the pressure being put on them by the opposition, led by former Senator Rick Santorum and Senator Mike Lee (R-UT). Santorum and Lee had managed to generate a large number of grassroots calls by grossly misrepresenting the purpose of the treaty. Right before the vote, Senate conservatives argued that the treaty gave the United Nations undue authority over U.S. sovereignty. They also asserted that the treaty's statement about "the best interest of the child" could be translated into laws prohibiting disabled children from being home-schooled. On the Senate floor Senator John Kerry explained the real purpose of the treaty. He said, "It really isn't controversial. What this treaty says is very simple. It just says that you can't discriminate against the disabled. It says that other countries have to do what we did 22 years ago when we set the example for the world and passed the Americans with Disabilities Act."
On Monday, the day before the vote, disability and civil rights advocates, including AUCD members, made last ditch pleas to the wavering Senators to vote in favor of the treaty. Several AUCD members, who were in town for the Annual Meeting, went to the Senate gallery to watch the historic vote. They also participated in a press event with former Senator and aging war veteran with disabilities, Bob Dole (KS), who pleaded for his Senate colleagues to vote in favor of the treaty. An alert was emailed to the network last week with a final vote tally. AUCD urges network members to contact their Senators. Thank those 61 Senators who vote in favor of the treaty (especially the 8 Republicans who voted with all of the Democrats) and urge those 38 Senators that voted "no" to reconsider when the treaty is brought back to a vote in the next Congress. Please visit AUCD's Action's Center to send a targeted message to your Senator depending on how they voted last Tuesday.
Autism
Defense Authorization Bill
During the Senate consideration of the National Defense Authorization Act (NDAA), Sen. Kirsten Gillibrand (D-NY) offered an amendment to increase the number of children with developmental disabilities in military families who can receive behavioral health services, including Applied Behavioral Analysis (ABA). The original amendment would have provided these services only to those children who have a formal diagnosis of autism. Sen. Patty Murray (D-WA) negotiated a change to the amendment to ensure that children with all types of developmental disabilities can access these services when they are prescribed by a physician. The House of Representatives passed a similar amendment to its NDAA bill; however, the House bill limits these services only to children with autism and does not include active members of the Coast Guard, the Commissioned Corps of the National Oceanic and Atmospheric Administration or the Commissioned Corps of the Public Health Service. The next step is for the House and Senate to appoint conferees to work out the differences in the two bills. AUCD signed onto a letter to the conferees along with other national disability, military family, and autism groups urging the House to recede to the Senate in regards to the behavioral health provision. AUCD also sent its own letter to conferees.
House Hearing on Autism
On Nov. 29, the House Committee on Oversight and Government Reform, chaired by Darrel Issa (R-GA), held a hearing titled, "1 in 88 Children: A Look Into the Federal Response to Rising Rates of Autism." Government researchers from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) were invited to provide testimony followed by a panel of self-advocates and autism advocacy organization representatives. Some of the questioning to the federal officials around the issue of vaccines and other research became quite contentious. The hearing webcast and written testimony are on the committee website.
Health Reform
Friday is the deadline for several hold-out states to decide whether they plan to set up their own insurance exchanges. The undecided states are Pennsylvania, Idaho and Tennessee. If those states don't want to set up exchanges entirely on their own, they have the option to work in partnership with the federal government or leave the task entirely up to the Federal Department of Health and Human Services. States also have a decision to make about whether to participate in the law's Medicaid expansion, though they don't face a deadline for making that call. Republicans have largely rejected the expansion, even though the federal government covers all of the additional costs in the first three years. On Thursday, the House Energy and Commerce Committee Subcommittee on Health will hold a hearing titled "State of Uncertainty: Implementation of PPACA's Exchanges and Medicaid Expansion." HHS and state health officials are slated to testify. Also on Thursday, the Senate Finance Committee holds a hearing on options for the reducing costs and improving the quality for patients who receive both Medicare and Medicaid.
Dually Eligible Beneficiaries
In a report released December 5, the Government Accountability Office (GAO) examined the disparate consumer protection requirements that apply to people who are dually eligible for Medicare and Medicaid benefits. The GAO took up this study because each program has separate requirements, which vary across payment systems and states, causing a complicated set of rules that dual-eligibles must navigate. The GAO identified several consumer protections of particular interest to dual-eligibles, including protections related to enrollment, provider networks and appeals. GAO found that states, programs, and payment systems vary widely in their consumer protections and Medicare and Medicaid have different appeals processes that do not align with each other. Medicare Advantage and state Medicaid programs require managed care plans to meet certain network provider requirements, but standards are not the same between programs.
For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms.
For copies of this and previous issues of Legislative News In Brief please visit the Public Policy Page of the AUCD website: http://www.aucd.org/template/page.cfm?id=164
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