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Fiscal Cliff
Negotiations continue on the so-called "fiscal cliff", the automatic spending cuts and tax increases scheduled for the beginning of 2013. In a small retreat from his previous position, House Speaker John Boehner (R-OH) has proposed allowing the top marginal tax rate to rise on income over $1 million in exchange for cuts to entitlement programs. The entitlement cuts that are being proposed, include raising the Medicare eligibility age from 65 to 67 and adopting the "chained CPI". The President has historically agreed to raising the Medicare eligibility age, but some Democrats have opposed the idea. The new CPI calculation would slow the growth of Social Security, Medicare, and Medicaid by reducing cost-of-living adjustments for beneficiaries. AUCD and CCD have argued against the chained CPI, and AUCD signed on to letters to Congress and the President opposing the chained CPI for its particularly harmful impact on SSI beneficiaries. Meanwhile, in good news to disability advocates, the White House has revealed that it no longer supports a blended rate for the federal Medicaid match, which would shift costs to states and harm beneficiaries AUCD emailed an Action Alert last week urging network members to voice concern about the state of the ongoing deficit reduction negotiations, specifically the importance of protecting non-defense discretionary programs against deep cuts.
Health Reform
HHS Issues Ruling on Medicaid Expansion
The Department of Health and Human Services has announced that the Centers for Medicare and Medicaid Services (CMS) will not allow states to partially expand Medicaid and receive the enhanced federal match under the Affordable Care Act. The ACA originally required states to expand Medicaid eligibility to all individuals with incomes below 133% of the federal poverty level with 100% federal coverage of the expansion through 2016 and enhanced federal match thereafter. Following the Supreme Court ruling on the ACA, states are no longer required to expand their programs, but some states have inquired as to whether the enhanced match could be applied to partial expansions of program eligibility. In a FAQ document on Exchanges, Market Reforms, and Medicaid, CMS explained that the ACA does not provide for a phased-in or partial expansion, so states must expand to 133% FPL to receive enhanced federal funds.
House Hearing on Exchanges and Medicaid Expansion
On December 13, the House Energy and Commerce Subcommittee on Health held a hearing titled "State of Uncertainty: Implementation of PPACA's Exchanges and Medicaid Expansion". Witnesses from the Centers for Medicare and Medicaid Services (CMS) included Gary Cohen, Director of the Center for Consumer Information and Insurance Oversight (CCIIO), and Cindy Mann, CMS Deputy Administrator/Director of the Center for Medicaid and CHIP Services (CMCS). Their testimony included current CMS efforts to implement the ACA, including health insurance market reforms, Essential Health Benefits rules, and guidance to states on implementing Exchanges and the Medicaid expansion. Other witnesses included secretaries of the departments of health of Louisiana, Wisconsin, Pennsylvania, Maryland, and Arkansas. Some of the secretaries expressed concern that Federal and state exchanges will be operational by October 1, 2013 and over of the cost of the Medicaid expansion.
Senate Hearing on Dually Eligible Beneficiaries
On December 13, the Senate Finance Committee held a hearing titled "Improving Care for Dually-Eligible Beneficiaries: A Progress Update". Witnesses included Melanie Bella, Director of the Medicare-Medicaid Coordination office within CMS and representatives from Arizona, Washington, and Ohio health departments. Washington and Ohio have recently signed MOUs with CMS on their demonstrations to align financing and care for duals. Several Senators, led by Senator Jay Rockefeller (D-WV) Chairman of the Finance Subcommittee on Health Care, expressed concerns about the demonstrations, arguing that managed care has not been shown to improve care for beneficiaries dually eligible for Medicare and Medicaid. Senator Rockefeller pointed to a GAO report that he requested on the consumer protections for those enrolled in both Medicare and Medicaid. For more information on the duals demonstrations, see AUCD's Health Reform Hub.
Rights/Class Action Bill
AUCD is happy to report that the Congress has decided not to take time to markup and pass H.R. 2032 in the Lame Duck session (see November 12th In Brief). However, despite Representative Frank's retirement this year, there is still the possibility that the bill will be reintroduced by a current co-sponsor or new member of the House. H.R. 2032 would restrict the ability of protection and advocacy systems to bring class action lawsuits to enforce the rights of individuals with intellectual and developmental disabilities in institutions. AUCD will continue to work with the Consortium for Citizens with Disabilities' Rights task force to prevent reintroduction of the bill in the new Congress.
Democratic Committee Assignments
On Dec. 12, the Democratic Steering Committee approved committee assignments for Democratic senators in the 113th Congress. Senate Majority Leader Harry Reid stated that "[t]hese committee assignments will allow all members of our caucus to bring their unique talents and expertise to bear as we work together to advance the interests of the middle class." Senator Murray (WA), a supporter of disability rights, will now chair the Budget Committee and remains on the HELP Committee. New to the Senate, Elizabeth Warren (MA) will join the HELP and Aging Committees. Senator Harkin remains chair of the HELP Committee and will be joined by Tammie Baldwin (WI), Chris Murphy (CT), and Warren (MA). The Budget committee welcomes newly elected Senators Baldwin (WI), Tim Kaine (VA), and Angus King (ME) and the Appropriations committee welcomes Senators Tom Udall (NM), Jean Shaheen (NH), and Jeff Merkley (OR).
The Disability Treaty
AUCD continues to work with the U.S. International Council on Disabilities (USICD) and other disability rights organizations to educate each Senator about the implications of their vote and the need to support the Convention on the Rights of Persons with Disabilities (CRPD) in the 113th Congress. The final vote of 61-38 was five votes short of the 2/3 vote needed to ratify (see last week's In Brief). This is a crucial time for us to use the media attention (see "CRPD in the News") on disability issues and let Senators know we will not accept a disregard of these rights. If your Center or organization has not already done so, please visit AUCD's Action Center to thank your Senators who stood up to the opposition and voted in support of the treaty, and urge those that voted "no" to reconsider when the treaty is brought back to a vote in the next Congress. For a status update on CRPD with new fact sheets and modified talking points, visit www.usicd.org.
AUCD Fellowship in Disability Policy Leadership
AUCD is accepting applications for the 2013 Disability Policy Leadership Fellow. Visit AUCD's homepage to find out more about this exciting fellowship opportunity. This is a fantastic opportunity for network members (faculty, trainees, etc.) to learn about disability policy development "hands-on." Visit AUCD's fellowship page to discover the work of the current and past fellows. If interested please send your letter of interest to Kim Musheno or the current fellow - Kristina Majewski - by January 31, 2012.
For definitions of terms used in In Brief, please see AUCD's Glossary of Legislative Terms.
For copies of this and previous issues of Legislative News In Brief please visit the Public Policy Page of the AUCD website: http://www.aucd.org/template/page.cfm?id=164
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