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Tax Bill
Early morning on December 2, the Senate narrowly approved (51 to 49) the tax bill. Senator Bob Corker (R-TN) was the only Republican to vote against the proposal. Like the House bill that passed last month, it had no public hearings and many Senators voiced concerns that they had very little time to meaningfully read the legislation. See section-by-section summary and summary of amendments.
Now Congress will have the month of December to work out substantial differences between the Senate and House bills (see Washington Post's "7 Differences that must be resolved between the tax bills"). The goal is to get a final bill to the President's desk by the end of the year.
While neither proposal directly cuts Medicaid, they dramatically cut the incoming revenue necessary to fund Medicaid, leaving it vulnerable to future cuts. In combination with the budget that passed three weeks ago - outlining over $1.1 trillion in cuts to Medicaid - if any tax bill passes the likely next step will be cuts to many domestic spending programs, including those relied upon by people with disabilities. This includes vocational rehabilitation, special education, HeadStart, and housing supports.
Collins-Nelson Bill
The tax bill passed by the Senate repeals the ACA's individual mandate, the requirement that most people have health insurance coverage. Senator Susan Collins argued that the harmful effects of repealing the mandate (i.e., higher premiums, more individual market instability, and 13 million more uninsured) could be mitigated if the President and Congress also adopted two additional pieces of legislation: the bipartisan individual market reform package from Senators Lamar Alexander and Patty Murray as well as the reinsurance bill from Senators Collins and Bill Nelson (reinsurance programs reimburse insurers for some or all of the costs associated with the highest-cost claims). The Collins-Nelson bill would provide $2.25 billion in net federal funding for reinsurance for 2018 and 2019 in federal funding for state reinsurance programs (equivalent to up to about $4.5 billion in gross funding in each year). However, the Collins-Nelson bill would not undo the mandate repeal's effects on premiums, market stability, or coverage. Please see CBPP report for more information". AUCD will continue to monitor this bill.
Graduate School Tuition Waiver Tax
As it stands, the House version of the Tax Cuts and Jobs Act would increase the tax burden on graduate students by counting waived tuition as personal income (see personal stories here). It eliminates the student loan interest deduction as well as the tax exclusion for tuition reimbursement received from an employer. It also cuts the Lifetime Opportunity Credit that benefits students enrolled in higher education for more than five years. The Senate version, on the other hand, does not and keeps the current exemption from taxation on graduate tuition waivers (see Section 117 of the U.S. tax code, which exempts "qualified tuition reduction"). What is left to be determined is whether the final version of the tax bill, will include an end to the exemption of tuition waivers from taxation.
Tax Bill Letters
AUCD along with a number of other national organizations signed onto a letter expressing strong opposition to the Senate's Tax Cuts and Jobs Act and our deep concerns about its effects on the health care of older adults, people with disabilities and their families.
Budget and Appropriations
Lawmakers face a budget showdown this week and must act by December 8 to keep the federal government operating. Over the weekend, House Appropriations Chairman Rodney Frelinghuysen introduced a two-week continuing resolution (CR) that would extend all provisions in the previous CR until December 22 (view the CR text here). Chairman Frelinghuysen confirmed that the two-week CR is meant to allow lawmakers more time to reach a deal on fiscal 2018 budget caps. Once that agreement is reached, appropriators will work with Senate leaders to draft and approve the 12 spending bills in light of the adjusted top-line spending levels. A second CR that runs into January would allow appropriators to complete their work (read Frelinghuysen's statement here).
The measure also includes a technical fix that would provide temporary aid for the Children's Health Insurance Program (CHIP). House Energy and Commerce Chair Greg Walden's proposal would allow states to "dip into" an existing pool of Centers for Medicare and Medicaid Services (CMS) funding that could help states whose programs are running out of money. However, this temporary "fix" would not include new funds to finance the program.
If a budget deal continues to elude Congress, sequestration, or across the board spending cuts, could be triggered and result in large cuts in both defense and non-defense programs (e.g., health care and health research programs, and education and training programs). This is because current spending levels are above spending caps, meaning even a CR would trigger the cuts.
Health Care
CHIP
In addition to the temporary fix described above, sources indicate that progress is being made towards a bipartisan deal to reauthorize children's health insurance and several other important health-care programs. The package would include funding for the CHIP and community health centers, and an extension of a range of other expiring Medicare programs. It could also include a bipartisan bill from the Senate Finance Committee known as the Chronic Care Act that seeks to make Medicare spending "more efficient and save money".
CAHPS survey
In the Fall of 2014, the Center for Medicaid and CHIP Services (CMCS) conducted a Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey of Medicaid enrollees to attain national and state-by-state measures of access, barriers to care, and experiences with care across delivery systems and major population subgroups. This survey provides baseline information on the experiences of low-income adults prior to a state's expansion of coverage to the new adult group that took effect on January 1, 2014. These data will be used to inform federal and state efforts to improve health care delivery for Medicaid enrollees. Read an issue brief and see infographics here.
21st Century Cures Act Hearing
On December 7, the Senate HELP committee will hold a hearing - Implementation of the 21st Century Cures Act: Progress and the Path Forward for Medical Innovation. Witnesses included Dr. Francis Collins (Director, National Institutes of Health) and Dr. Scott Gottlieb (Commissioner, Food and Drug Administration).
Education
HEA Reauthorization
On December 1, Representatives Virginia Foxx (R-NC), chairwoman of the House Committee on Education and the Workforce and Brett Guthrie (R-KY), chairman of the Higher Education and Workforce Development subcommittee, introduced H.R. 4508, the Promoting Real Opportunity, Success, and Prosperity through Education Reform (PROSPER) Act. AUCD is concerned with the negative impact this proposal will have on students with disabilities. As it is currently written, the bill it does not include accessible materials requirements (AIM HIGH Act) for institutions of higher education (for on-line or other curriculum and program materials), nor does it include the RISE Act, which provides high school students and families with information about accommodations and supports as well as ease of documentation for students with disabilities transitioning to higher education. AUCD will continue to work with Members of Congress in order to make this a more comprehensive bill that supports students with disabilities.
Hearings
On December 7, Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, (R-Tenn.) will vote on the nominations of Mitchell Zais to be deputy Education secretary, and James Blew to be assistant Education secretary for planning, evaluation, and policy development.
Employment
Hearings
On December 7, Senate Health, Education, Labor and Pensions Committee (Chairman Lamar Alexander, R-Tenn.) markup to vote on the nominations of Kate O'Scannlain to be solicitor of the Labor Department, and Preston Rutledge to be an assistant Labor secretary.
Home and Community Based Services
On December 1, Senate Finance Committee Ranking Member Senator Wyden (D-OR), and House Energy and Commerce Ranking Member Pallone (D-NJ), announced a letter to CMS Administrator Seema Verma expressing serious concerns about Iowa's recently approved amendment to the State's Section 1115 Medicaid waiver. The letter highlights the significant risks posed by eliminating Medicaid's guarantee of retroactive coverage, particularly on people with disabilities and aging populations who rely on Medicaid's long-term care services.
Emergency Preparedness
On November 30, the Transportation and Infrastructure Committee held a Full Committee markup of the Disaster Recovery Reform Act (DRRA), H.R. 4460. The DRRA is bipartisan legislation that addresses the rising costs of disasters in the United States, and reforms federal disaster programs (e.g., Federal Emergency Management Agency's - FEMA's) to ensure communities are better prepared for future natural disasters. Title 2 Section 209 Assistance to Individuals and Household amends the Stafford Act to "increase the amount of assistance available to individuals with disabilities" and subsection 4
States that "the maximum amount of assistance established shall exclude expenses to repair or replace damaged accessibility-related improvements for individuals with disabilities". AUCD will continue to monitor this bill.
Tuesdays with Liz: Disability Policy for All
In this week's edition of Tuesdays with Liz: Disability Policy for All, Liz interviewed Senator Maggie Hassan from New Hampshire about her agenda for this Congress. (Please note this interview was filmed last week, on November 29th, 2017. The 'Tax Cuts and Job Act' bill, which is referred to by Senator Hassan, was passed by the Senate on December 2nd, 2017).
In case you missed the week prior, Liz interviewed In case you missed last week's edition, Liz interviewed Cecilia Feinstein, the UCEDD Director at the Institute on Disabilities at Temple University, about AUCD's new strategic roadmap."
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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