Disability Policy News In Brief

January 15, 2018

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January 15, 2018   |   Vol. XV, Issue 157
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Sources indicate that Congress is discussing the possibility of passing yet another continuing resolution on January 19 to keep the government from shutting down. Appropriators are divided, however, on how long they think the temporary funding extension should last. Negotiations continue toward a budget solution for the remainder of the fiscal year, including sticky issues like: defense and nondefense budget caps, health care, disaster relief, and the President's renewed call for his proposed border wall to be included in any deal regarding the Deferred Action for Childhood Arrivals (DACA) program, which he plans to end in March.

Health Care

Medicaid Work Requirements

On January 10, Centers for Medicare and Medicaid Services (CMS) announced new guidance that will support state efforts to "improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries". CMS stated that the policy responds to numerous state requests to test programs through Medicaid demonstration projects (i.e. Section 1115 Waivers) under which "work or participation in other community engagement activities (including skills training, education, job search, volunteering or caregiving) would be a condition for Medicaid eligibility for able-bodied, working-age adults". This would exclude individuals eligible for Medicaid due to a disability, elderly beneficiaries, children, and pregnant women.

The new policy guidance sent to states aims to "help design demonstration projects that promote the objectives of the Medicaid program and are consistent with federal statutory requirements". Noteworthy, CMS has previously rejected proposals such as this stating that it "could undermine access to care and [does] not support the objectives of the Medicaid program." It has also been shown that work requirements in other programs have failed to increase long-term employment, and some people who lose benefits under work requirements fall deeper into poverty. In contrast, Medicaid coverage supports work by giving low-income people access to the care they need to find and hold a job.

State specific: On January 12, CMS approved an 1115 Medicaid waiver for Kentucky that includes work requirements (first time ever approved), premiums, two-month waiting periods for coverage, six-month lockouts for failure to make payments on time or quickly report changes, and other provisions that will create new barriers to coverage and care.

AUCD is concerned with the potential unintended consequences of this guidance as it could negatively affect health equity, people with disabilities, and people who use reproductive health services. Though certain exemptions were made for people with disabilities, the definition under which people with disabilities would be categorized is left up to the state for interpretation and could result in a number of people being included in these demonstrations. AUCD will continue to monitor the ramifications of this guidance and work with CMS to ensure that people with disabilities receive appropriate, affordable, and comprehensive care while also having opportunities for meaningful employment.

Note: Section 1115 demonstrations and waiver authorities in section 1915 of the Social Security Act are vehicles states can use to test new or existing ways to deliver and pay for health care services in Medicaid and the Children's Health Insurance Program (CHIP). Please find all current and concluded state programs authorized under these authorities here. Also, learn more about the section 1915(b), section 1915(c), and section 1115 authorities.


Permanent funding for the CHIP reauthorization effort has been stalled for months given disagreements between parties on how to pay for it. Last week, the Congressional Budget Office (CBO) issued a new cost estimate that now puts the cost of a five-year extension at just $800 million (down from $8 billion). The reason for the lower cost is due in part to the repeal of the Affordable Care Act's (ACA) individual mandate, which will result in premiums increasing. If CHIP were not continued, many children would need to enroll in ACA plans, which would now be the more expensive option due to the expected rise in premiums.

Given the new analysis, sources indicate that reauthorization of CHIP could be attached to a short-term government funding bill that must pass before the continuing resolution expires on January 19. House Energy and Commerce Committee Chairman Greg Walden (R-OR) stated "I don't think that will be a problem." CBO also indicated that a 10-year (as opposed to a 5-year) CHIP extension would actually save roughly $6 billion, but Chairman Walden does not think it would be possible to approve a 10-year extension.

Social Security

On January 11, the Social Security Advisory Board (board) released the culmination of two years' work pertaining to the Social Security Administration's (SSA's) representative payee (rep payee) program. The report, Improving Social Security's Representative Payee Programoutlines concrete steps to protect vulnerable Social Security beneficiaries and recipients. The report includes recommendations for Congress, the Office of Management and Budget and SSA to strengthen the current administrative process, create better monitoring and explore comprehensive, government-wide coordination and cross-agency reform of rep-payee processes. A link to these recommendations may be found here


On January 11, the U.S. Commission on Civil Rights released Public Education Funding Inequity in an Era of Increasing Concentration of Poverty and Re-segregation. Based on extensive research and expert testimony, the report addresses pervasive disparities in funding for public education, and offers actionable recommendations with a goal of improving educational opportunity and student achievement for all of our nation's student population. See the full report along with key findings and recommendations here.

On January 18, the Senate Health, Education, Labor and Pensions Committee (Chairman Lamar Alexander, R-Tenn.) will hold a hearing on financial aid simplification and transparency in the Higher Education Act. View live webcast and list of witnesses here.

RAISE Family Caregivers Act

On January 8, the Senate passed H.R. 3759, the Recognize, Assist, Include, and Engage (RAISE) Family Caregivers Act by voice vote, which was then sent to the President to be signed into law. This bipartisan legislation was introduced by Senators Collins (R-ME), Baldwin (D-WI), Murkowski (R-AK) and Bennet (D-CO), and Representatives Harper (R-MS), Castor (D-FL), Grisham (D-NM) and Stefanik (R-NY) and aims for the development of a national strategy to support the nation's more than 40 million unpaid caregivers. The RAISE Act would bring together stakeholders from both the public and private sector to create an advisory body, which would then develop recommendations on how to better recognize and support family caregivers. AUCD has been and continues to be in support of this legislation and has worked closely with Members of Congress to ensure its passage.

New Appointments

On January 9, Senate Democratic Leader Chuck Schumer announced the Senate Democratic committee memberships for the 2nd Session of the 115th Congress. All memberships have been ratified by the Senate Democratic Steering and Outreach Committee and by the full Democratic Caucus later today. Note that with the exception of the Joint Economic Committee, which has a two-vote margin by statue, all Senate committees will now have a one-vote margin.

On January 17, Senate Finance Committee (Chairman Orrin G. Hatch, R-Utah) will vote on the nominations of Alex Azar II to be Health and Human Services secretary and Kevin McAleenan to be commissioner of U.S. Customs and Border Protection; the committee will also consider subcommittee assignments.

Tuesdays with Liz: Disability Policy for All

This week, Liz interviewed Judy Heumann, a Senior Fellow at the Ford Foundation and a long-time disability advocate, about her early educational experiences as someone with a disability and the importance of the UN Convention on the Rights of Persons with Disabilities (which the US has yet to ratify). In case you missed last week, Liz interviewed Dan Habib about the shortcomings of assessing intelligence through IQ tests and discusses his upcoming film, 'Intelligent Lives.' Dan Habib is a documentary film director who focuses on disability-related topics and a Project Director at the Institute on Disability at the University of New Hampshire.

Editor's Note: These episodes of Tuesdays with Liz have been pre-recorded. Liz Weintraub is currently on sabbatical 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.



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

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