AUCD Legislative News InBrief
December 3, 2007
Congressional Schedule
Congress returns from a two week Thanksgiving break to a busy schedule. Work includes the 11 unfinished annual spending bills for this fiscal year. Comprehensive energy legislation, the 2007 farm bill, free-trade agreements, and the defense authorization bill are also among the list of priorities that could be considered before the first session of the 110th Congress adjourns for the year.
Appropriations
Eleven of the 12 annual spending bills for the fiscal year that began Oct. 1 are still pending (only the defense bill has been signed into law). The president vetoed the bill to fund the departments of Labor and Health and Human Services that provides most disability program funding, saying the bill cost too much. The Administration wants to cut programs funded under the Labor-HHS-Education bill by $6.7 billion, or 4.5 percent, below existing funding levels for these programs, adjusted only for inflation. Congress, in contrast, would increase funding by $5.2 billion, or 3.5 percent. Senate Majority Leader Reid (D-NV) offered a compromise level for all the remaining appropriations bills that represents half of the increase that Congress wants. The House and Senate Appropriations committees this week will attempt to put together the remaining 11 spending bills based on this slimmed down funding target. The deadline for final approval is Dec. 14, when the continuing resolution under which most of the government is operating expires. An omnibus bill is considered likely given the time restraints. It is still uncertain whether the President will continue to oppose bills that provide any increase over his funding proposal. AUCD continues to communicate its priorities to key appropriators working on disability program funding. AUCD network members are encouraged to continue communicating with their Members of Congress about the need for increased funding to continue to the important work of the Centers.
SCHIP
House Majority Leader Hoyer (D-MD) announced late last week that Democratic leaders have decided to send the SCHIP reauthorization bill to the President to be vetoed again. Negotiations between the Senate Finance Committee and House Republicans did not result in revisions to gain needed votes to override the veto. In the absence of a deal, the next step will likely be to continue the program without any changes. This will result in some children losing health insurance coverage. According to the Congressional Research Service, nine states could run out of FY08 money by March, and 21 will likely be forced to reduce coverage by the end of next year if they do not receive the additional funding authorized in the vetoed bill. See Families USA website for analyses of how the SCHIP proposals will affect state funding: http://www.familiesusa.org/.
Medicare and Medicaid
The Senate Finance Committee is expected to mark up a Medicare package this week to address a scheduled 10% cut in physician payments. Details of the package are still being negotiated. It is uncertain whether it will be a one or two year fix and how it will be paid for. It is anticipated that some funding will be provided through reductions in payments to Medicare Advantage (managed care) plans. The House included a broad range of Medicare changes in its bill to reauthorize SCHIP. It is possible that some of these provisions could make it into the Senate package; however, they would need to be offset (paid for by cuts in other programs). AUCD and other disability groups are hopeful that the Medicare bill will be a vehicle for the moratorium on proposed Medicaid rules that would cut school-based and habilitation services. The Consortium for Citizens with Disabilities (CCD) organized a "Dear Colleague" letter asking Chairman Baucus (D-MT) and Ranking Member Grassley (R-IA) to include the moratorium language. The letter was signed by 39 Senators. In addition, last week AUCD signed on a CCD letter to the Finance Committee containing additional recommendations for the Medicare bill. In addition to the Medicaid moratorium language, recommendations include addressing the 75% rule on Medicare inpatient rehabilitation, therapy caps on outpatient Medicare rehabilitation, improvements to Medicare Part D, mental health parity in Medicare, and access to complex rehab and assistive technology and power wheelchairs. More details on these issues and recommendations are in the CCD letter:
http://www.aucd.org/docs/policy/health_care/ccd_medicare_letter_11.29.07.DOC
Hate Crimes
AUCD signed on a CCD letter urging Congress to include hate crimes legislation in the final Department of Defense Authorization Conference Report. The Senate included the language in their bill. In May, the House voted 237-180 to approve a stand-alone hate-crimes bill that is similar to the Senate language.
Work Incentives
The National Ticket to Work Advisory Panel releases its final report today at a press event in Washington, DC. The report will be posted on the Panel's website at http://www.ssa.gov/work/panel/panel_documents/reports.html later this month. The Ticket to Work and Work Incentives Improvement Act established the Advisory Panel within the Social Security Administration to advise the President, the Congress and the Commissioner of Social Security on issues related to work incentive programs, planning and assistance for individuals with disabilities and the Ticket to Work and Self-Sufficiency Program established under the Act. AUCD signed onto CCD testimony during the development of the report with concerns regarding some of the interim recommendations. AUCD will provide an analysis of the report once it is made available to the public.
Medicaid/Targeted Case Management Rules
The Centers for Medicare & Medicaid Services (CMS) interim final rule with comment period (IFC) implementing section 6052 of the Deficit Reduction Act of 2005 (DRA) clarifies the Medicaid definition of covered case management and targeted case management (TCM) services. The rule includes measures to address concerns about improper billing of non-Medicaid services to the Medicaid program by some states. The rule narrows those eligible by defining case management and excluding certain activities. The rule is expected to save $1.2 billion over five years. The public comment period will close 60 days from the date of publication in the Federal Register (expected Dec. 4). The rule's provisions will be effective 90 days after publication. To view the rule, visit: http://www.cms.hhs.gov/MedicaidGenInfo/08_Medicaidregulations.asp. If you have comments on this rule, please send them to [email protected]. AUCD will be joining CCD to provide comments.
AUCD Legislative Affairs Committee
AUCD meets this week with The Arc, United Cerebral Palsy, American Association on Intellectual and Developmental Disabilities, and American Network of Community Options and Resources to update the joint legislative goals for the Second Session of the 110th Congress. The partners will assess input from organization members, assess laws up for reauthorization, as well as to take into consideration the congressional leadership agenda and political context. Following the work of the partnering organizations, the AUCD Board will be asked to adopt the goals in time for the Second Session to begin, most likely in mid January. These goals will be mailed to all Members of Congress and used by participants of the annual policy seminar.
