AUCD Legislative News In Brief

July 8, 2013

AUCD Legislative News In Brief
  July 8, 2013   |  Vol. XIII, Issue 27
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Congressional Schedule

Both chambers return from recess today. The next few weeks will be very busy as both houses rush to finish work before the month-long August recess. The Senate is expected to address student loan interest rates, while the House is expected to take up immigration reform, reauthorization of the Elementary and Secondary Education Act, and a revised farm bill. In addition, there are several hearings and markups on bills that may impact people with disabilities.  Today, the House Energy and Commerce Subcommittee on Health is sponsoring a hearing on the "Impact of Affordable Care Act on Medicaid."  The House Education Committee will has scheduled a hearing on "Innovations in Higher Education;" and the Senate Labor, HHS, Education Appropriations Subcommittee will mark up its annual appropriations bill for FY 2014.

Affordable Care Act Implementation

Employer Mandate

The Department of Health and Human Services announced last week a delay of the Affordable Care Act requirement that large employers provide insurance to full-time employees or pay a penalty. The move came in response to concerns from employers that they needed more time to comply with the law. Under the ACA, employers with more than 50 full-time employees are required to provide affordable health insurance by January 1, 2014 or pay a fine. This decision delays that requirement until January of 2015. The Department has said that this delay will not affect the availability of insurance through the Health Insurance Marketplaces or requirement that individuals obtain health insurance by January 1, 2014 because most employers who would qualify for the requirement already offer insurance.  The House has announced plans to hold hearings on the delay.

Implementation Final Rules

The Department of Health and Human Services released final regulations regarding the Health Insurance Marketplaces, Medicaid, and Children's Health Insurance Program in regards to implementation of the ACA. Most important for people with disabilities, the rule finalized regulations on the benefit packages that will be available to people newly eligible for Medicaid under the expansion, including the habilitation benefits available through the Essential Health Benefits provided in the benefit package. The regulation also allows for greater cost-sharing for prescription drugs and for non-emergency uses of emergency room visits by Medicaid beneficiaries and addresses eligibility notices and appeals and presumptive eligibility.

A separate rule released last week, HHS finalized regulations regarding those who will be exempt from the "individual mandate" to carry health insurance. The rule finalizes several exemptions from the policy, including members of federally recognized Indian tribes and their dependents, people who experience a hardship, individuals with a "coverage gap" of less than three months, and members of certain religious sects. The rule requires that the Exchanges determine exemption for those based on religious conscience, financial hardship, Indian tribe membership, health care ministry membership, and incarceration; the IRS will determine other exemption categories through the regular tax filing process. AUCD is still reviewing these final rules.

Direct Support Workforce

The Department of Labor has announced that they plan to finalize rules regarding minimum wage and overtime protection for direct support professionals and other home care workers. The Department originally proposed the change in December 2011 to end the exemption of home care workers from minimum wage and overtime pay requirements. The exemption dates back to 1974, when Congress sought to exempt babysitters and other "companionship services" from the Fair Labor Standards Act. Since then, the nature of long-term services and supports has shifted dramatically toward support and medical care provided in homes. The rule has been controversial; labor unions strongly support the enhanced protections for workers but some disability advocates have been concerned that increased wages for home care workers could limit access to home-based services by substantially increasing the cost. There has also been concern that the rule could unintentionally limit the use of family caregiving, shared living, and other forms of natural support.

Community First Choice Option

The Oregon Department of Health and Human Services has announced that the Centers for Medicare and Medicaid Services (CMS) have approved their application to implement the Community First Choice Option (CFCO). Oregon is only the second state to be approved for CFCO; California was the first. CFCO is a Medicaid option created by the Affordable Care Act to expand access to home and community-based services. States who take up the option must provide home and community-based services statewide to Medicaid eligible individuals with incomes up to 150% of the federal poverty level, with no caps or targeted populations. States will receive a 6 percentage point increase in their federal Medicaid matching rate for CFCO services. More information on the option is available at Please let AUCD staff know if your state is planning to use the CFCO.


A new national non-profit organization called RespectAbility has just launched, with the mission of reshaping attitudes of American society and empowering people with disabilities so that they can more fully participate in and contribute to society. According to their website, "RespectAbility will work to educate, sensitize and engage Americans to focus on what people with disabilities can do, rather than on what they cannot do. RespectAbility thereby will seek to help increase the number and percentage of Americans with disabilities who engage in gainful employment, start and sustain their own businesses, lift themselves into the middle class, and participate in their communities -- as fully as their abilities and efforts will take them." The organization has already announced trainings for disability leaders and funders and fellowships for future disability leaders. More information is available at their website,


For more policy news, follow Kim and Rachel on Twitter at @kmusheno and @racheljpat

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:

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