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Congressional Schedule
Both chambers are in session, facing a busy schedule of bills before the August recess. The Senate is expected to vote this week on a bill to lower student loan interest rates, while the House will debate the reauthorization of the Elementary and Secondary Education Act.
Appropriations
On July 11, the Senate Appropriations Committee passed, 16-14, its Fiscal Year 2014 Labor HHS, Education Appropriations bill. The Labor HHS bill would provide $164.3 billion in discretionary spending for the departments of Health and Human Services, Labor and Education, $7.8 billion more than the pre-sequester FY2013 level and $42.5 billion more than what the House Appropriations panel has allocated for its Labor HHS bill. The table below shows the Senate Committee's recommendations compared to the President's budget, FY 2013 final appropriations after sequestration cuts, and FY 2012 for programs within or followed closely by the AUCD network. Read on for a funding table and more information about our network programs...
Health Reform Implementation
Final Implementation Rules: Navigators
The Department of Health and Human Services issued a final rule regarding Health Insurance Navigators, the organizations responsible for helping individuals understand their health insurance options and enroll in coverage, including Medicaid coverage, through the Health Insurance Exchanges. The rule creates conflict-of-interest, training and certification, and meaningful access standards including culturally and linguistically appropriate services and access for people with disabilities. These standards are applicable to Navigators and non-Navigator assistance personnel (including Certified Application Counselors and In-Person Assisters) in Federally Facilitated and State Partnership Exchanges, as well as non-Navigator assistance personnel in State Exchanges. In short, the requirements apply to organizations and individuals who are funded through Federal dollars to navigate and assist individuals with enrollment, not those funded by State Based Exchanges or other state dollars.
The rule also makes requirements for training: that all Navigators and non-navigator assistance personnel in Federal Exchanges be trained on Qualified Health Plans and all other insurance affordability programs offered by the state. HHS offers this rule as guidance on training to states operating State-Based Exchanges, but they are free to develop their own training. Navigator training for Federally Facilitated Exchanges will be provided directly by CMS. In response to comments from the disability community, consumers seeking health insurance can select anyone they chose as their "authorized representative" to assist with health insurance enrollment; the previous role limited authorized representatives to those with legal authorization, like legal guardians. More information is available on the Health Affairs blog and a CMS fact sheet on the roles of different assistance personnel.
Employer Mandate
In response to the announcement that the Department of Health and Human Services will delay mandates for large employers to provide affordable health insurance (see last week's In Brief), the House has planned a series of hearings and votes regarding the employer and individual mandates. The House Ways and Means Committee will hold a series of hearings on the mandate delay and the authority of the administration to delay implementation without amending the ACA. Two bills in the Ways and Means Committee address the delay: H.R. 2667 would codify the delay of the employer mandate and H.R. 2668 would delay the individual mandate for a year. The Energy and Commerce Subcommittee on Oversight and Investigations has also scheduled a hearing this week on the delay.
Education
This week, the House is expected to begin debate on a bill to reauthorize the Elementary and Secondary Education Act. The Student Success Act (H.R. 5), introduced by John Kline (R-MN), chair of the Education and the Workforce committee, would eliminate federal standards for achievement, including achievement of students with disabilities, and allow states to develop their own accountability systems. Specifically, the bill would eliminate caps on the percentage of students who can take alternate assessments, a change that AUCD and the Consortium for Citizens with Disabilities have strongly opposed. AUCD has prepared a side-by-side comparison of the disability provisions in existing law, H.R. 5, and the Senate version of the reauthorization.
Long-Term Care Commission
Members of the Leadership Council of Aging Organizations and Consortium for Citizens with Disabilities, including AUCD staff, and met with Larry Atkins, current president of the National Academy of Social Insurance and newly appointed staff-director of the Long-Term Care Commission. Atkins stressed that given the short time frame (the commission must produce a report by September 12), the commission hopes to focus on areas of agreement and common ground and to build momentum to continue work to address the issue of long-term services and supports in the future. He also shared that while his background is in aging, he hopes to provide equal emphasis to the LTSS needs of younger people with disabilities. The commission has not yet launched its website, but there will be an online mechanism for public comment open soon. The commission held its first meeting on June 26 and plans to meet again July 17. The commission was established as part of the "fiscal cliff" deal that repealed the CLASS program (see January 7 In Brief).
Autism
Senators Patty Murray (D-WA), a member of the Veterans' Affairs Committee and Kirsten Gillibrand (D-NY), a member of the Armed Services Committee, wrote a letter to the Department of Defense last week expressing outrage over new restrictive rules that would limit and possibly deny care for children of military families. The letter was written in response to new policy guidance issued on June 25 by TRICARE affecting ABA coverage for all TRICARE-eligible beneficiaries. According to the new guidance, TRICARE will now require:
- standardized testing every 6 months in order to continue receiving care
- evidence of "measurable progress" as indicated by standardized testing results to receive continued therapy
- waivers to continue care beyond two years of treatment and after age 16
- new discharge criteria for failure to make progress, sustainable gains, or a parent's inability to participate in the treatment
The Senators urged the head of TRICARE to explain how the restrictive rules that require standardized testing, limit the eligibility of treatment, and set an age limit on receiving the care were determined and urged the agency to consult with experts before the new rules go into effect on July 25th.
The Senators also point out that this new guidance comes on top of earlier policy changes last year that resulted in children with developmental disabilities, other than autism, losing access to ABA. In the letter, the senators urge the Secretary of Defense for Health Affairs to "consult with experts in developmental disabilities such as autism and ABA treatment practices," before these policies go into effect. See the full letter here.
Food Assistance
On July 11, the House of Representatives passed a stand-alone farm bill, reauthorizing farm assistance programs but removing the Supplemental Nutrition Assistance Program (SNAP, or "food stamps") from the bill (the two programs are traditionally reauthorized together). The Federal Agriculture Reform and Risk Management Act (FARM Bill) originally failed on June 20, to the surprise of many working on the issue, in part because it included large cuts to food stamps (see June 24 In Brief).
New National Poll Released: First Study on the Political Views of People with Disabilities
On Tuesday, July 9th, a briefing was held at the National Press Club in Washington, D.C. for the release of the Youth Transition Collaborative's national poll results: "Power in Numbers: A Profile of American Voters with Disabilities." Overall, the survey found that people with disabilities and chronic conditions are as politically diverse as the general population in America. However, respondents overwhelmingly reported they would vote against a candidate they would usually support if that candidate supported cuts to existing government services for people with disabilities. The survey also highlighted the role of young people with disabilities, showing evidence of an emerging generation of advocates and voters who may be more engaged in the political process. Power in Numbers is a product of the National Youth Transitions Collaborative advocacy working group that includes the American Association of People with Disabilities, Autistic Self-Advocacy Network, The HSC Foundation, Institute for Educational Leadership, National Council on Independent Living, and United Cerebral Palsy.
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: http://www.aucd.org/template/page.cfm?id=164
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