AUCD Legislative News In Brief
June 21, 2010
Medicaid
Senate leaders failed twice last week to garner the 60 votes necessary to end filibuster and move the tax extenders package forward. The bill contains a six-month extension of the temporary increase in the federal share of Medicaid spending (known as the FMAP) set to expire December 31. Senate Majority Leader Harry Reid (D-NV) has begun breaking the bill into smaller pieces in hopes of moving less controversial provisions forward, but the larger package is not likely to move unless leaders can come up with a way to offset its cost. Reid, however, is not giving up and has decided to continue work on the bill this week instead of moving on to other legislation. Without an extension of the enhanced FMAP, many states will be forced to make drastic cuts to their Medicaid programs. To contact your Senators about this issue, visit AUCD's Action Center.
Budget and Appropriations
Budget Resolution
Neither chamber appears capable of producing a FY 2011 budget resolution to establish spending caps on discretionary programs. With no anticipated support from House and Senate Republicans, Democratic leaders do not seem confident about gaining sufficient support from fiscally conservative members. Without a resolution, Congress will have to pass a deeming resolution that would set the cap on discretionary spending for the new fiscal year beginning October 1. With Congress in session only nine weeks prior to the start of the new fiscal year, it is virtually certain that the majority of the twelve appropriations bills will not be enacted before October 1, thus forcing Congress to adopt a continuing resolution to keep the federal government operating. In any case, human services discretionary spending is not expected to increase for many programs.
Education Funding
Work on the House supplemental spending bill for the wars in Iraq and Afghanistan is stalled as fiscally conservative Democrats work to offset its costs. Appropriations Chairman David Obey (D-WI) proposed adding $23 billion in education funding to prevent as many as 300,000 teacher layoffs in the coming year, however, conservative House members have said they would oppose including the money in the supplemental if it is not paid for. Liberals are pushing for a separate vote on the war spending, but it is unclear whether there would be enough votes to pass the non-war provisions if they are not attached to the war funding.
"Do Not Pay" List
Amid calls for Federal agencies to find ways to trim at least five percent from their budgets and $8 billion worth of federal building costs, President Obama last week ordered the Treasury Department, Office of Management and Budget (OMB), and General Services Administration to establish a government-wide "do not pay list" database to ensure agencies no longer send government checks to delinquent or jailed contractors, and other ineligible people or organizations. Plans are also in the works for the Centers for Medicare and Medicaid Services (CMS) to trim waste by implementing an online fraud-detection program. According to OMB, about 20,000 separate payments totaling $182 million were sent to people no longer living in the last three years, and CMS made $65 billion in erroneous payments in fiscal year 2009.
Health Reform
Last week, Department of Health and Human Services Secretary Kathleen Sebelius announced the availability of $500 million in new funding provided by the Affordable Care Act. $250 million will be allocated to expand the primary healh care workforce and $250 million is allocated to support prevention and public health activities (the first payment from the new prevention trust fund). The new funding will help prepare the health system to meet the demand for health care workers as well as in community and clinical prevention, public health infrastructure, research and tracking, and public health training. A fact sheet entitled, Creating Jobs and Increasing the Number of Primary Care Providers is available for more information on expanding primary workforce and a prevention and public health investment fact sheet will be available at www.healthreform.gov.
The White House expects to launch its web portal to the Pre-Existing Condition Insurance Plan on July 1. The Plan is the temporary high-risk pool established by the new health reform law to be run by the federal government for those states which choose not to run their own programs. The Plan is one of the early benefits of health reform designed to cover those individuals with pre-existing conditions who have not been insured for the six months prior to application. Twenty states have elected to have the U.S. Department of HHS run the high risk pool program in their states: AL, AZ, DE, FL, GA, HI, ID, IN, KY, LA, MN, MS, NE, NV, ND, SC, TN, TX, VA, and WY. (UT and RI are undecided.) HHS has requested more information from the states that have volunteered to run their own pool programs about how they intend to operate them. The temporary high-risk pools will continue until 2014 when access to the health insurance exchanges becomes available. Coverage is intended to begin August 1.
Education
Four states have recently submitted requests for a waiver of the maintenance of effort (MOE) requirement in the Individuals with Disabilities Education Act (IDEA). The MOE prevents states from reducing the state and local government's share of IDEA funding, and can only be waived in exceptional circumstances. The U.S. Department of Education reviews waiver requests on a case-by-case basis with regard to a number of important factors, including the requirement that every student covered by IDEA receive a free and appropriate public education. The Department has approved MOE waivers for Kansas and Iowa; requests submitted by South Carolina and West Virginia are still under review. The Office of Special Education and Rehabilitative Services (OSERS) released a memorandum today explaining the factors it considers when reviewing a waiver request. Part C of IDEA does not allow for such waivers.
Olmstead
The Senate Health, Education, Labor and Pensions (HELP) Committee will hold a hearing on enforcement of the Americans with Disabilities Act and the Supreme Court's Olmstead decision on Tuesday. The hearing will focus on ensuring community opportunities for individuals with disabilities. For more information and to view the hearing, visit the committee's website.
Americans with Disabilities Act
U.S. Secretary of Transportation Ray LaHood announced Thursday the first federal rule to specifically provide Americans with Disabilities Act (ADA) protections to people with disabilities who travel on boats and ships. The action comes as the 20th anniversary of the ADA approaches on July 26. Under the rule, vessel operators cannot charge extra for accessibility-related services to passengers, require passengers to furnish their own attendants, or deny access to passengers based on disability. This rule does not establish physical accessibility standards for new construction or alteration of vessels, however. The new rule will become effective 120 days after it is published. There will be a 90-day comment period. For more information and instructions for submitting comments, view the pdf at regulations.gov.
