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Budget & Appropriations
Program funding - LEND & UCEDD
As reported in last week's In Brief, due to the President's FY19 Budget Request eliminating funding for the Health Resources Services Administration Autism CARES Act programs and cutting funds for UCEDDs by $6 million, AUCD encourages directors, health professionals, trainees, families and allies to continuing educate their Members of Congress on why these programs are important for your community.
Please use the AUCD Action Center to send an email (which you can personalize) to your Members of congress: advocating for and/or educating about the importance of LEND; advocating for and/or educating about the importance of UCEDD.
Health Care
Marketplace Stabilization
Members of Congress in both the House and Senate continue discussing whether a package of policies aimed at stabilizing the individual health insurance market will be included in the Omnibus package that must pass by March 23rd. Among items being discussed are how to address the short-term and association health plan rules in legislation (comment period is still open), reinsurance, cost-sharing reduction payments (see below), enhancing subsidies, and other items that could either help or harm marketplace enrollees. All of this also is impacted by discussions of how the Hyde amendment, restricting federal funds for abortion, would apply to the package. The White House has also publicized a document of items it wants to see in a stabilization package.
Within the stabilization dialogue, a centerpiece of the debate has been whether making Cost Sharing Reduction (CSR) payments would be helpful or harmful to marketplace enrollees. Many Members of Congress have been pushing for CSR funding and some would like to see it included in the omnibus as well. This has been an ongoing priority since last fall when two bipartisan bills were introduced: one by Senators Alexander and Murray that would restore cost-sharing reduction (CSR) payments to insurers, among other changes; the other introduced by Senators Collins and Nelson that would provide federal funding for state reinsurance programs.
Background: when CSR payments were not appropriated last year, insurers and states adjusted through "silver loading" the lack of payment, effectively increasing the amount of premium tax credits flowing to low- and modern- income marketplace enrollees. Given this, AUCD is concerned that if CSR payments were to be made now, low- and moderate-income enrollees would actually be more negatively impacted. AUCD supports the need to swiftly stabilize the market, but CSR payments should not be made unless there are protections in place for low- and modern- income marketplace enrollees.
Accelerating Access to Kids Care Act
On February 12, Senators Grassley (R-IA) and Bennet (D_CO) introduced a bill to facilitate out-of-state care for children covered by Medicaid. The Accelerating Access to Kids Care Act (S. 2415) would allow "a provider or supplier of medical or other items or services" to elect to go through a screening and enrollment process, established by the Secretary of Health and Human Services, that would qualify them to provide services or supplies "furnished to a child for which payment is available under the State Medicaid plan that is located in another state." The Congressional Budget Office Has not yet provided a cost estimate, but presumable it would not be very costly to implement. AUCD supports this proposal and is reviewing its potential impact.
Health Equity
In 2017, The National Academies of Sciences, Engineering and Medicine convened a roundtable on The Intersections Among Health Disparities, Health Equity, and Health Literacy and commissioned a paper to be presented at the workshop. Disability Rights Education & Defense Fund (DREDF) Senior Attorney Silvia Yee and Sr Policy Advisor Mary Lou Breslin were selected as the lead team in authoring the paper titled "Compounded Disparities: Health Equity at the Intersection of Disability, Race, and Ethnicity." The final paper is now available, which concluded "if we are going to increase health equity and improve health outcomes for people with disabilities-particularly those at the intersections of diverse race, ethnicity, and language characteristics-the covert biases and discrimination against these populations will require us to correct the false assumptions about disability, race, and ethnicity that underlie the way we deliver health care, the historical development of our public health systems, and our disregard for the health disparities experienced by some groups as a natural consequence of being in the group, rather than inequities to be corrected."
Medicaid Waivers
On February 8, the Trump Administration said Idaho would not be allowed to sell the state-based insurance plans it sought to sell alongside policies on the health care law's exchange next year. Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said that these state-based insurance plans would not be complying with the 2010 health care law. Verma stated in a letter to Idaho Governor Otter that the statue "remains the law and we have a duty to enforce and uphold the law."
On February 5, the Trump administration approved Arkansas's request to impose work requirements on certain Medicaid beneficiaries. This makes Arkansas the third state to receive approval to impose work requirements that included a requirement for recipients to work, participate in job training or job search activities for at least 80 hours a month. However, the administration did not make a decision on a dual request to roll back the eligibility level for Medicaid beneficiaries, which would reduce the Medicaid eligibility cap from 138% of the federal poverty level to 100%. Governor Hutchinson (R) said he is continuing to work with the administration. If that provision is approved, combined with the work requirements, an estimated 60,000 people are projected to lose coverage. Please see Kaiser Health News for more information.
Hearing
On March 15, Labor, Health and Human Services, Education and Related Agencies Subcommittee (Chairman Tom Cole, R-Okla.) of House Appropriations Committee will hold a hearing on the FY2019 Health and Human Services Department Budget.
Education
Protection and Advocacy
AUCD sent a letter of support regarding a new bipartisan bill - Protection and Advocacy (P&A) for Students with Disabilities Act - introduced by Representatives DeSaulnier (D-CA) and MacArthur (R-CT). This legislation would establish a new P&A to serve students with disabilities in schools and other educational settings. Representatives DeSaulnier (D-CA) and MacArthur (R-CT) circulated a "dear colleague" letter requesting cosponsors.
Higher Ed Act Recommendations
Recently, HELP Chairman Lamar Alexander and Ranking Member Patty Murray invited disability community recommendations on the reauthorization of the Higher Education Act. As part of a workgroup of inclusive education experts and joined by over 100 state and national disability groups, AUCD developed and joined a letter submitting recommendations specifically addressing inclusive postsecondary education and the Model Comprehensive Transition and Postsecondary Programs for Students with Intellectual Disabilities (TPSIDs). AUCD also signed onto a Consortium of Citizens with Disabilities letter of recommendations, which is more comprehensive in including recommendations for the entirety of the Higher Ed Act, and also included recommendations on the TPSID program.
Impact Aid
Representative Banks (R-IN) introduced a bill (HR 5199) that would create Education Savings Accounts (ESA) for military families, using money now given to school districts that receive federal Impact Aid. Impact Aid, a $1.3 billion program that has been around for decades, helps school districts to make up for tax revenue lost because of a federal presence, such as a Native American reservation or military base. The proposal, by Rep. Banks, would give some of that money directly to families through ESAs. The accounts could be used for tutoring, private school tuition, and more. Senators Sasse (R-NE) and Scott (R-SC) recently introduced a companion bill as well (S 2517). AUCD is concerned with loss of Impact Aid funding to districts as well as the challenges presented to students with disabilities in accessing needed support in settings that fall outside the protection of IDEA.
Sexual Assault
A recent report from the National Council on Disability, "Not on the Radar: Sexual Assault of College Students with Disabilities" found that the needs of students with disabilities are often not addressed under existing policies. To address this gap and build upon the work of landmark legislations - Jeanne Clery Act and the Americans with Disabilities Act - Senators Casey and Hassan introduced the Safe Equitable Campus Resources and Education (SECuRE) Act (S.2530). See press release for details. AUCD is a supporter of this bill.
ADA Education and Reform Act (H.R. 620)
AUCD is very concerned that ADA Education and Reform Act bill would negatively impact people with disabilities and the efforts to ensure communities are inclusive and accessible. Advocates are encouraged to continue educating their Members of Congress on the importance of the ADA, a law that has now been in place for over 25 years. Here are resources for you educating efforts:
2018 Disability Policy Seminar
Please remember to register for the Disability Policy Seminar (DPS) and the AUCD Trainee Summit, which will take place on Sunday, April 22! 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. 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).
Please save the date: Trainee orientation webinar - April 2nd at 3:30-4:30pm EST - which will highlight what you can expect, how you should prepare, and an opportunity to ask questions!
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.
Eager to learn more about trends in IDD services across the states? Liz talks to Amie Lulinski, Research and Development Coordinator at the Coleman Institute for Cognitive Disabilities, in this throwback episode of TWL about the AAIDD publication, "The State of the States in Intellectual and Developmental Disabilities: 2017".
For more from AUCD, follow @AUCDNews and like AUCD on Facebook
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
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