Disability Policy News In Brief

2018 Budget Deal

On Friday, House and Senate leaders passed a 6-week long continuing resolution (CR) that was signed into law by the President (PL 115-123). This (CR) that runs through March 23 was paired with a two-year budget deal (Bipartisan Budget Act of 2018) that will raise spending caps on defense and non-defense discretionary (NDD) program categories for 2018 and 2019 by $290 billion.

The Budget Act:

• Significantly increases defense caps by $80 billion for FY18 and FY19.
• Increases non-defense discretionary spending by $63 billion in FY18 and $68 billion in FY19
• Provides $89.3 billion for disaster relief funding; $4.9 billion of which is provided to increase Medicaid caps for Puerto Rico and U.S. Virgin Islands for two years.
• Authorizes $3 billion for FY18 and $3 billion for FY19 to address the opioid epidemic and support mental health programs. The opioid funding would go toward state grants to fight drug abuse and expand substance abuse and mental health treatment.
• Cuts the Prevention and Public Health Fund (PPHF) by $1.35 billion over 10 years (this is less than the $2.85 billion cut in the alternative passed by the House earlier last week), but restores cuts to the PPHF made in December 2017 to offset Children's Health Insurance Program (CHIP) funding in the near-term, and cuts funding to PPHF in out-years (FY2022-2027).
• Extends CHIP for an additional four years (now 10 years total).
• Reauthorizes and increases funding for Community Health Centers for two years, the National Health Service Corps for two years, and extends other expired health programs. (However, Money Follows the Person was not included and as such, continued education of your Members of Congress is still needed).
• Includes five years of funding for the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV).
• Provides National Institutes of Health with $1 billion for FY18 and $1 billion for FY19 to support additional scientific research.
• Provides $2 billion for FY18 and FY19 to reduce the VA healthcare maintenance backlog.
• Provides $10 billion for FY18 and FY19 to invest in infrastructure, including programs related to rural water and wastewater, clean and safe drinking water, rural broadband, energy, innovative capital projects, and surface transportation.
• Provides $2.9 billion for FY18 and FY19 for child care, including the bipartisan Child Care Development Block Grant program.
• Provides $2 billion for FY18 and FY19 for student-centered programs that aid college completion and affordability.
• See ACCESS Act for sections of the Health and Human Services Extenders.

The Congressional Budget Office estimated the budget agreement would add $320 billion to annual deficits over 10 years, with most of the impact felt over the three fiscal years ending in 2020. That comes on top of the tax code overhaul (PL 115-97) signed in December, which is expected to add at least $1.1 trillion to the 10-year deficit, with over half of the revenue loss occurring by the end of fiscal 2020.

This $320 billion measure also set new increased fiscal 2018 budget caps, enabling appropriators to write the 12 spending bills for the fiscal year that began Oct. 1, 2017. Members of Appropriations Committees now need to introduce and pass these FY2018 bills that will meet the new budget caps, to keep funding going through September 30, the end of the fiscal year.

2019 President's Budget Proposal

The President's budget for fiscal year 2019, released today, provides a detailed guide to the budget, tax, and program changes the Trump Administration seeks to achieve for FY2019.  It will be the first articulation of budget priorities since enactment of the new tax law. While the budget won't reflect this week's congressional budget agreement (described above) raising funding for defense and non-defense discretionary (annually appropriated) programs, it remains important, for two main reasons. First, it presents not only the President's proposed funding levels for individual discretionary programs but also the broader fiscal agenda, including how the Trump Administration wants to change major entitlement programs as well as tax policy.

This FY 2019 budget, which is only a proposal, includes:

• $1.5 trillion infrastructure package aimed at overhauling U.S. public works.
• Reducing the National Institute of Child Health and Human Development (NICHD) to $1.34 billion; $31 million below the Administration's FY 2018 request.
• Reducing the Department of Education to $59.9 billion, a $7.1 billion or 10.5-percent decrease from the 2017 enacted level.
• $1.1 billion in school choice programs; $500 million to establish a new school choice grant program to support school choice vouchers and $500 million to fund the opening, expansion, and replication of charter schools.
• $12.8 billion for IDEA formula grants to States to support special education and early intervention services, and $222 million for discretionary grants to States, institutions of higher education, and other nonprofit organizations to support research, demonstrations, technical assistance and dissemination, and personnel preparation and development.
• Restructuring and streamlining the TRIO and GEAR UP programs (evidence-based postsecondary preparation programs) by consolidating them into a $550 million State formula grant.
• Maintaining the $1.1 billion in funding for Career and Technical Education.
• Eliminating funding for 29 discretionary programs that "do not address national needs, duplicate other programs, are ineffective, or are more appropriately supported with State, local, or private funds". These eliminations include the Supporting Effective Instruction State Grants, 21st Century Community Learning Centers, and Federal Supplemental Educational Opportunity Grant programs.
• Reducing funds or consolidating 13 programs such as those supporting Minority Serving Institutions, TRIO, GEAR UP, and Federal Work Study.
• Investing $200 million in apprenticeships.
• Eliminating $451 million in other health professions and training programs.
• Prohibiting certain reproductive/family planning providers from receiving Federal funds from HHS, including those that receive funding under the Title X Family Planning program and Medicaid, among other HHS programs.
• Level funding for TPSID programs at $11.8 million.
• "A two-part approach to repealing and replacing the Affordable Care Act, starting with enactment of legislation modeled closely after the Graham-Cassidy-Heller-Johnson (GCHJ) bill as soon as possible, followed by enactment of additional reforms to help set Government healthcare spending on a fiscal path that leads to higher value spending."
• Medicaid Impact of the "Repeal & Replace" approach reduces funding by $2,885 million in 2019, $429,395 million through 2023, and $1,389,235 million through 2028.

Here is a Snapshot of the HHS Budget. See full HSS budget in brief here.

Hearings

The Senate Finance Committee (Chairman Orrin G. Hatch, R-Utah) will hold three hearings on "The President's FY2019 Budget", February 14-15. Witnesses will include Steven Mnuchin, secretary of the Treasury, David Kautter, acting IRS commissioner and assistant Treasury secretary for tax policy, Alex Azar, secretary, Department of Health and Human Services.

February 13, the Senate Committee on Budget will also hold a hearing on the "President's FY 2019 Budget Proposal". Witnesses include Mick Mulvaney, Director Office of Management and Budget. The following day, the House Budget Committee will hold their hearing on "the President's Fiscal Year 2019 Budget". Mick Mulvaney will participate as well.

ADA Education and Reform Act of 2017

This week, the House of Representatives is expected to vote on H.R. 620, a bill that impacts the Americans with Disabilities Act (ADA). The ADA is civil rights legislation which prohibits discrimination based on disability and requires reasonable accommodations for employees with disabilities, as well as accessibility in public accommodations. H.R. 620 would require a person with a disability to provide a business with a legal notice detailing how architectural barriers violate the ADA, impose a six-month waiting period to resolve the violation, and extends the resolution if "progress" is made. After passage of the ADA, places of public accommodation-that is, privately owned, leased, or operated facilities-were required to take proactive steps to be reasonably accessible to people with disabilities. Since its inception, businesses have now had more than 25 years to ensure that people with disabilities have access to their community. AUCD is concerned that this bill would roll back disability rights and inclusion. This week is an important time to educate your House members on the importance of the ADA, civil rights, and that people with disabilities should not have to wait for their right of accessibility and service that all citizens have access to immediately. See AUCD's talking points here.

Health Care

Steve Gleason Enduring Voices Act of 2017

On Friday, Congress approved the Steve Gleason Act of 2017 (S 1132, HR 2465), a bill that ensures that beneficiaries with ALS, MS, Parkinson's disease, paralysis, cerebral palsy, and other conditions will be assured that Medicare coverage for speech generating devices (SGD) and related accessories will continue to be available. AUCD along with the Center for Medicare Advocacy and 80 other organizations and professionals worked together to advocate for the importance of this bill.

Medicaid Lifetime Caps

At least five states - Arizona, Kansas, Utah, Maine and Wisconsin - are seeking waivers from the Trump administration to impose lifetime Medicaid coverage limits. The Department of Health and Human Services said it could not comment on the pending applications. AUCD is concerned with imposing caps on health care as this could have a devastating impact on people with disabilities. For example, children who are born with chronic health care conditions could reach lifetime caps within a few weeks of being in a hospital, resulting in the family having to take on expensive health care services. In addition, low-wage workers who may not get health coverage through their jobs could also quickly reach their Medicaid coverage limit. Attaching time limits and work requirements to Medicaid coverage does not meet a basic requirement of HHS waiver experiments and demonstration projects - to further the objectives of the Medicaid program, such as improving coverage, health outcomes and access to providers

2018 Disability Policy Seminar

Please remember to register for the Disability Policy Seminar (DPS). Registration for the AUCD Trainee Summit, on Sunday, April 22, will be open soon! DPS is a great opportunity to learn about disability policy, advance the grassroots movement for people with intellectual and developmental disabilities, advocate for access to health care, community living supports and civil rights, share your story with Members of Congress, and more. Also, remember to schedule meetings with your Senators and Representatives before you come to DC (tips sheets on how to do this will be shared soon).

2018 AUCD Gala

To highlight and raise the visibility of the great work being done by the AUCD network in state capitols around the country, we are inviting each center to submit a short write-up of a state policy initiative and success that your center or program has played a role in. Please use this form to help guide your submission. We ask that submissions be 500 words or less and if you have pictures to enhance your story please include them as well. Please submit your stories by Friday, February 23^rd.

Tuesdays with Liz: Disability Policy for All

The Tuesdays with Liz series is taking a break while Liz Weintraub is on detail working with the Senate Aging Committee. Tuesdays with Liz will return to a regular taping schedule and new episodes will air in the late Spring when Liz returns to AUCD. Until then, we will be highlighting some of our favorite Tuesdays with Liz episodes from this past year here and on social media at @AUCDnews.

This week, we'd like to bring you back to when Liz sat down with  Lee Page, Senior Associate Director of Advocacy at the Paralyzed Veterans of America. In the interview, Lee explains the ADA Education Reform Act (HR 620), how HR 620 threatens enforcement of the ADA, and the role of state versus federal law in upholding the ADA.

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

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