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Debt Ceiling Negotiations and Budget
On June 3rd, President Biden signed The Fiscal Responsibility Act of 2023. The bill represents a bi-partisan compromise after months of negotiations regarding how to raise the debt ceiling. The bill suspends the debt ceiling through January 2025 in exchange for spending caps, new work requirements for TANF and food stamp recipients, rescinding unspent pandemic aid and other changes. For non-defense discretionary spending (NDD) the bill is an improvement over the Limit, Save, Grow Act (passed by the House Republicans) because it extends the debt limit longer, has less drastic cuts to programs, and changes to Medicaid are not included.
The bill establishes budget caps for Fiscal Year (FY) 2024 and 2025 for both defense and non-defense discretionary (NDD) spending. For FY 2024, the bill would cap top-line discretionary spending at $1.58 trillion or approximately 6.7 percent less than FY 2023. For FY 2024, defense spending would be limited to $886.3 billion, approximately 3 percent more than FY 2023, and NDD would be limited to $703.6 billion, approximately 9 percent or $70 billion less than the FY 2023. For FY 2025, the bill would allow for 1 percent growth over FY 2024, capping top-line discretionary spending at $1.606 trillion and limiting defense spending to $895.2 billion and non-defense spending to $710.7 billion.
There is also an incentive for Congress to act on all appropriations bills before January 1, 2024. If they do not, FY23 spending levels will be cut by an additional 1 percent until all bills are passed, this applies to both defense and non-defense spending.
Furthermore, the bill has no impact of Medicaid. The bill does include new work requirements for food stamp and TANF recipients without children up to age 54. (The law previously applied to those 49 and younger.) Veterans, the homeless, and people who were children in foster care are exempt from work requirements.
Lastly, the bill also ends the President's suspension of student loan repayments by September 1; it rescinds approximately $28 billion in unobligated COVID-19 funding, including funds made available through the American Rescue Plan Act (ARPA), Coronavirus Aid, Relief and Economic Security (CARES) Act, and other pandemic-related spending bills; reforms energy project approvals to shorten the process; and rescinds $1.38 billion from the IRS and repurposes another $20 billion from the $80 billion the IRS received through the Inflation Reduction Act.
Plain Language
On June 3rd, President Biden signed The Fiscal Responsibility Act of 2023. This bipartisan (Democrat and Republican supported) raised the debt ceiling. The debt ceiling is the most amount of money that the federal government can spend, and this bill allows the federal government to spend more money.
In order to raise the debt ceiling, many Members of Congress wanted cuts to some federal spending. The Fiscal Responsibility Act put a limit on the amount of money the federal government can spend in 2024 and 2025. There are some new work requirements for the Supplemental Nutrition Assistance Program (SNAP) for people below the age of 54. Work requirements are a number of hours a person has to work in order to receive SNAP. This bill has no impact on Medicaid.
Centers for Medicare and Medicaid Services Releases Two Notices of Proposed Rulemaking Around Medicaid and Managed Care
On April 27th, the Centers for Medicare and Medicaid Services CMS) released two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM). The rules will help eliminate barriers that people with disabilities face while trying to access quality health care through Medicaid and Children's Health Insurance Program (CHIP). The rules will “strengthen access to and quality of care across Medicaid and the Children's Health Insurance Program (CHIP), the nation’s largest health coverage programs.”
If the proposed rules are adopted, they would establish national standards for access to health care, regardless of whether health care is provided through managed care plans or directly by states through fee-for-service as well as transparency for Medicaid payment rates to providers, including hourly rates and compensation for certain direct care workers. The rules would also establish other access standards for transparency and accountability and empower beneficiary choice. The rules would require that 80% of Medicaid payments for personal care and home health aides go directly toward compensation instead of on administrative costs.
Plain Language
On April 27th, the Centers for Medicare and Medicaid Services released two new rules that would make it easier for people with disabilities to get health care if they are on Medicaid or CHIP. These rules will also improve wages for home healthcare workers who are giving care to people through home and community-based services.
Action Steps
Learn more about the rules. Submit comments by July 3, 2023. Read the Rule and Submit Comments for Medicaid Program; Ensuring Access to Medicaid Services. Read the Rule and Submit Comments for Medicaid Program; Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality.
“Creating Community, Commenting on the HCBS Access Rule” Webinar on Wednesday, June 7th!
AUCD, Autism Society of America, National Disability Rights Network, and National Association of Councils on Developmental Disabilities are holding a virtual workshop to learn more about the new proposed rule from Medicaid around HCBS. The workshop will cover the contents of the rules, and how you can submit comments to the Centers for Medicare and Medicaid Services. Plain Language and closed captioning provided. Click here to register!
The House and Senate Introduce Legislation Aimed at Improving Interactions Between People with Disabilities and Law Enforcement
On May 17th, the House and Senate introduced bills aimed at addressing the increased incidence of violence involving law enforcement and people with disabilities. Research shows that 33-50 percent of all use-of-force instances with law enforcement involve people with mental health disabilities, which is disproportionately higher than total population with mental health disabilities.
Senator Casey (D-PA), Rep. Higgins (D-NY-26), and Rep. Fitzpatrick (R-PA-1) introduced the Human-Services Emergency Logistics Program (HELP) Act (S. 1729 / H.R. 3498). This bill will divert non-criminal, non-fire, and non-medical emergency calls from 911 systems to state and regional systems that support people in crisis related to a mental health condition, like 211 and 988. The bill provides resources and oversight for 211 and 988 systems to ensure that they work correctly.
Senator Casey (D-PA) and Representative Wild (D-PA-7th) introduced the Safe Interactions Act (S. 1731 / H.R. 3550). This bill will provide grants to enable non-profit disability organizations to develop training programs that support safe interactions between law enforcement and people with disabilities. The training would include people with disabilities as instructors. An advisory council chaired by a person with a disability would be established to oversee the training development and implementation.
Senator Casey (D-PA) introduced the Data Interactions and Accountability for Law Enforcement with Individuals with Disabilities (DIALED) Act (S. 1730). This bill will amend the Death in Custody Reporting Act and the FBI Use of Force Data Collection Program to improve accuracy and transparency of data collection on how people with disabilities are affected by interactions with law enforcement, including use-of-force and fatal interactions. A national advisory council will also be established to develop improved collection and reporting strategies.
Plain Language
On May 17th, the House and Senate introduced bills to address police violence and people with disabilities. The first bill is the Human-Services Emergency Logistics Program (HELP) Act. This bill will give money to non-criminal, non-fire, and non-medical emergency call systems like 211 and 988. 211 and 988 are phone numbers like 911 but are used for things like mental health emergencies. This bill will support people with disabilities in emergency situations.
The second bill is the Safe Interactions Act. This bill will give money to disability organizations to create training programs for police officers on best ways to help people with disabilities. The trainings will be taught by people with disabilities and will be given to all current and new police officers.
The third bill is the Data Interactions and Accountability for Law Enforcement with Individuals with Disabilities (DIALED) Act. This bill will help collect data on interactions between people with disabilities and the police. Data is information on how often something happens. People with disabilities are more likely to be victims of police related violence, and this bill will allow the public to see how often this happens.
Action Steps
Read more about all 3 bills from Senator Casey’s office. Call and educate your Senators and Representative on the importance of ensuring people with disabilities are safe in emergency situations and during interactions with police. You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121.
Policy related “How To” materials can be found on our website here. Scroll to the bottom of the page to find the resources!
Tuesdays with Liz: Did you know that Liz has a YouTube Channel?
Tuesdays with Liz is a monthly video series highlighting current issues in disability policy. It is hosted by Liz Weintraub, a long-time disability advocate, and produced by AUCD.
You can help spread her message by:
- Subscribing to the Tuesdays with Liz YouTube Channel!
- Liking videos on the channel
- Sharing videos on your social media accounts
 
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For definitions of terms, please see AUCD's List of Policy Definitions
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