AUCD Legislative News InBrief
September 4, 2007
Congressional Schedule
Congress returns today from a month-long recess to a busy schedule that includes work on appropriations and reauthorization of SCHIP. Senate Majority leader Reid (D-NV) hopes for a conference in September on SCHIP, with action possible on an FDA reauthorization bill, a conference report on higher education legislation and perhaps another debate on stem cell legislation, which President Bush vetoed earlier this year. The Workforce Investment Act and No Child Left Behind Act are also on the list, but there may not be enough time to complete work on these two major items given the major differences in policy proposals among the Republicans and Democrats.
Fiscal Year 2008 Appropriations
With the Oct. 1 new fiscal year fast approaching, passing the 12 annual appropriations bills will be at the top of the congressional agenda this month. The House of Representatives has passed all 12 FY 08 appropriations bills. The Senate has managed to pass only one, the Homeland Security funding bill. Appropriations analysts expect the Senate to take up the Military Construction, Transportation/HUD/VA, and Defense spending bills first. Senate Majority Leader Harry Reid (D-NV) has already indicated that he is not planning to bring the Labor-HHS-Education bill to the floor for a vote, making it increasingly likely that Congress will wrap it up in an "omnibus" spending package with one or more other bills. This strategy will make it harder for the President to veto the bill. If the President still vetoes the bill and there are not enough votes to override it, Congress will have to rewrite a bill that would meet the President's approval. For more information about the House and Senate funding levels in the L-HHS-ED bills, see the July 16 In Brief. Over the August recess, AUCD met with House and Senate subcommittee staff to shore up support for network funding priorities. AUCD also encouraged its network through its recess action alert to meet with their members of Congress to discuss funding issues important to people with disabilities and families.
Health/SCHIP Reauthorization
Congress will continue work on reauthorization of the State Children's Health Insurance Program (SCHIP) which is set to expire on September 30. Before the August recess, the House and Senate each passed legislation to reauthorize the program. The two versions differ substantially. The next step will be for a House-Senate conference committee to work out differences. The committee's work is made even more difficult due to the threat of a Presidential veto. While SCHIP helps provide coverage to nearly 6.1 million children, approximately 9 million children remain uninsured in the United States. Children with disabilities and their families face many difficulties obtaining adequate coverage in the private market. The Senate bill would provide an additional $35 billion over 5 years to cover approximately 3.2 million additional children. The House bill, the Children's Health and Medicare Protection (CHAMP) Act, would provide an additional $50 billion to cover approximately 5 million more children. The Kaiser Kamily Foundation has issued a new brief that summaries key issues in the SCHIP debate.
The CHAMP Act also includes many important provisions that would greatly benefit individuals with disabilities. Some of these provisions would:
- Prevent restrictions to certain Medicaid rehabilitation and school-based services.
- Eliminate the institutional bias and financial hardship of Medicare Part D (prescription drug) cost-sharing for dual eligible beneficiaries living in community settings.
- Protect classes of Medicare Part D prescription drugs (including anticonvulsants and antidepressants) that are important to many people with disabilities and allow beneficiaries to change plans in mid-year if plans stop coverage for prescribed drugs.
Over the August Recess AUCD created an action alert to support reauthorization of SCHIP and inclusion of disability provisions contained in the CHAMP Act: http://capwiz.com/aucd/issues/alert/?alertid=10206761.
The CCD Health Task Force is sponsoring a free conference call on Wednesday, September 5 from 3:00-4:00 PM EST. Jeff Crowley from the Georgetown University Health Policy Institute will provide an overview of the Medicare and Medicaid disability provisions in the CHAMP Act. Contact Joe Caldwell at AUCD for the call-in number and conference ID at [email protected]
CMS Guidance Letter on SCHIP
On August 17 the Centers for Medicare and Medicaid Services (CMS) issued a regulatory guidance letter on "crowd out." "Crowd out" refers to the effect of substituting coverage in the private market for public coverage. The CMS letter sets guidelines and assurances states must meet if they enroll children from higher income families (above 250% of the federal poverty level) in SCHIP. Some states have expressed concerns that the new guidelines are unrealistic and would effectively prevent many states from continuing or expanding coverage of children above 250% of poverty. Advocates have expressed concern over the political timing of the Administration's release of the guidance letter and the legal foundation for such significant changes in policy without Congressional debate.
Census Data on Uninsured
Last week the US Census Bureau released data indicating that the number of people in the United States without health insurance rose by more than 2 million in 2006, including about 700,000 million children. A total of 47 million people were without insurance coverage last year, the Census Bureau said, up from 44.8 million in 2005. The percentage increase, 15.8 percent, is the highest since 1998. According to the Census Bureau, there were 8.7 million uninsured children in 2006, up from 8 million the previous year.
Medicaid Rehabilitation Services Option
One of the provisions in the House SCHIP bill would establish a one-year moratorium to prohibit the Department of Health and Human Services from restricting coverage or payment for rehabilitation services. This provision is important given recently released proposed regulations by CMS. Jeff Crowley recently released a Kaiser Family Foundation brief on how restrictions would impact individuals with disabilities: http://kff.org/medicaid/upload/7682.pdf. This issue will also briefly be discussed on the Sept. 5 grassroots call mentioned above.
No Child Left Behind
Last week the House Education and Labor Committee released a draft bill to reauthorize the No Child Left Behind Act (NCLB). The Committee may consider the bill as early as this month. There is no clear timeline for reauthorization in the Senate. The draft was developed through input received at hearings this year as well as from advocacy groups. Comments are due September 5. The CCD Education Task Force, of which AUCD is a member, provided recommendations to the Committee and is currently analyzing the draft bill. The draft is available on the Committee website at http://edlabor.house.gov/ and was emailed to the AUCD Legislative Affairs Committee and education work group. Please send any comments or suggestions to Kim or Joe at the AUCD office.
ADA Restoration
During the August recess AUCD legislative affairs staff met with several House Republican members to gain co-sponsors for the ADA Restoration Act (H.R. 3195). The US Chamber of Commerce recently wrote to Members of Congress in opposition of the bill. Similar opposition was voiced during consideration of the original Act. The bill currently has 182 co-sponsors, including 39 Republicans. Because the bill shares jurisdiction with several committees attaining as many co-sponsors as possible will help with passage. You can see if your Representative has co-sponsored the bill at the following link:
http://capwiz.com/aucd/issues/bills/?bill=10102496&cs_party=all&cs_status=C&cs_state=ALL
AUCD has created an action alert to urge Representatives to co-sponsor the bill: http://capwiz.com/aucd/issues/alert/?alertid=10069101
Vocational Rehabilitation Act
During the August recess AUCD legislative affairs staff met with Senate Health Education Labor and Pensions (HELP) Committee staff to review a draft bill to reauthorize the Vocational Rehabilitation (VR) Act. The VR Act is Title IV of the Workforce Investment Act (WIA) which has been up for reauthorization for several years. The HELP Committee may consider moving the Vocational Rehabilitation Act separately this fall. Overall, the Senate bill places more emphasis on services for students with disabilities transitioning from school to work, supported employment, and supporting individuals with disabilities in the community. AUCD is generally supportive of the Senate bill but is reviewing the new provisions and will be submitting comments and recommendations. For more information, contact AUCD legislative affairs staff.
CLASS Act
Advocacy groups continue to work to increase the number
of co-sponsors for the Community Living Assistance Services and Supports (CLASS) Act. Republican members who have
expressed interest and are current targets for possible co-sponsors include
Senators Specter (R-PA) and Enzi (R-WY). AARP recently signed on in support of
the bill. Senator Kennedy also plans to discuss the bill with Senate colleagues
at an upcoming Democratic caucus meeting on long-term care. AUCD has prepared
an Action Alert to encourage members of the House and Senate to co-sponsor the
CLASS Act: http://capwiz.com/aucd/issues/alert/?alertid=9839346
Direct Support Professionals Fairness and Security Act
AUCD recently signed onto a letter of support of the H.R. 1279, the Direct Support Professionals Fairness and Security Act of 2007. ANCOR, The Arc of the United States, United Cerebral Palsy and Lutheran Services in America are planning a rally and Hill visit day on September 11 to gain support for the bill.
Positive Behavior for Effective Schools Act
AUCD signed onto a letter of support for the Positive Behavior for Effective Schools Act (H.R. 3407), introduced August 3 by Representatives Hare (D-IL), Loebsack (D-IA), Woolsey (D-CA), and Danny Davis (D-IL). This bill amends the Education and Secondary Education Act to provide the flexibility, encouragement, and technical assistance to schools to implement positive behavior supports school-wide, not only for students with disabilities. AUCD previously signed onto a letter organized by the Balezon Center suggesting similar recommendations to Congressional committees working on No Child Left Behind reauthorization.
National Letter on Fernald Closing
AUCD signed onto a national letter organized by the National Disability Rights Network (NDRN) encouraging the State of Massachusetts to appeal a recent U.S. District Court decision concerning the closure of Fernald Developmental Center (Ricci v. Okin). The state's plans for closing the institution were halted by the ruling of Judge Joseph L. Tauro that long-time residents must be given the opportunity to stay. Many national disability groups fear this case would set a new precedent that would make it difficult for other states to take active steps to transition from institution to community-based residential services.
GAO Study on Federal Medicaid Waiver Process
The Government Accountability Office (GAO) released a critical report of the federal approval process for Medicaid 1115 Demonstration waivers. The report focuses on the Florida and Vermont waivers and expresses concern about the Department of Health and Human Services' lack of information and opportunity for public input: http://www.gao.gov/cgi-bin/getrpt?GAO-07-694R.
Joseph P. Kennedy Public Policy Fellowship
The application deadline for Joseph P. Kennedy Public Policy Fellowship is September 14. The fellowship provides an opportunity for professionals in the field of developmental disabilities and family members to engage in a one-year intensive fellowship in Washington, DC. For more information visit: www.jpkf.org