On October 4, The House Energy and Commerce Committee also approved several bills addressing a variety of issues supported by The Arc including extending funding for community health centers (H.R.3922), a two year extension of the Family to Family Health Information Centers, extending the Medicare Independence at Home Medical Practice Demonstration (H.R.3263) making permanent a provision that allows Medicare coverage for speech generating devices (H.R.2465) and several other bills. Unfortunately, the Committee also voted to reduce $6.35 billion from the Prevention and Public Health Fund over 10 years. The fund supports many prevention and public health programs throughout the country.
On October 4, the Senate Finance Committee passed the Keeping Kids’ Insurance Dependable and Secure (KIDS) Act (S.1827). This bipartisan bill reauthorizes federal funding for the next five years to the Children’s Health Insurance Program (CHIP), a program which currently provides low-cost health insurance to roughly 8.9 million children under the age of 18 who do not qualify for Medicaid or have access to private insurance. Current federal funding expired on September 30 at the end of FY 2017. However, some states have been able to carry over this federal funding and keep their programs running longer than others. The Finance Committee has not yet indicated how they plan to fund the $8 billion needed for CHIP to continue. The bill is set to move to the Senate floor for consideration after the forthcoming recess.
Also on October 4, the House Energy and Commerce Committee passed the Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) Act of 2017 (H.R.3291). This bill also reauthorizes the federal funding for the CHIP program for five years. While there was bipartisan agreement on the reauthorization, the Committee members disagree about how to pay for the bills. The bill included an increase in Medicare premiums for high income people, changes to Medicaid third party liability provisions and changes to the treatment of lottery winners to pay for the reauthorization.
The Senate Budget Committee passed its fiscal year 2018 Budget along a party line vote of 12 to 11 on October 5. It also passed an amendment by Senator John Kennedy (R-LA) for implementing work requirements for all means-tested federal “welfare” programs. The Senate Budget provides instructions to the Finance Committee to allow the Committee to increase the deficit by to $1.5 trillion over the next decade. In addition to taxation, the Finance Committee has jurisdiction over Medicaid, Medicare, Temporary Assistance to Needy Families, and other health and human services programs. The Senate Budget also assumes trillions of dollars in cuts to mandatory programs and proposes a cut of nearly 30% in inflation adjusted dollars to non-defense discretionary programs by 2027.
The full Senate is expected to take up the measure the week of October 16. If it passes as expected, it will set up a conference with the House to iron out the substantial differences between their budgets. If both chambers are able to pass the same version, it could allow for legislation that can be passed by a simple majority (51) in the Senate. Click here for an analysis of the Senate 2018 Budget Resolution.
The House passed its fiscal year (FY) 2018 Budget Resolution (H.Con.Res.71) on October 5 by a vote of 219 to 206. While tax reform is the stated priority of the majority party for this budget, there are numerous provisions that would be very harmful to people with disabilities. The House Budget Resolution has stronger language than the Senate Budget Resolution calling for trillions of dollars in spending cuts over a decade, including to programs such as Medicaid and Medicare. The House Budget also assumes the adoption of an Affordable Care Act repeal bill that has not advanced. It does not allow for tax cuts to increase the deficit, also unlike the Senate’s Budget. Instead it provides instructions to 11 committees for $203 billion in spending cuts and proposes to cut nondefense spending by $5 billion, while increasing defense spending by $72 billion. Click here for The Arc’s statement on the House passage of its 2018 Budget Resolution.
People across the United States are talking about the need for paid family and medical leave. New research by The Arc and the Georgetown Center on Poverty and Inequality (GCPI) highlights how access to paid leave can promote economic security and stability for people with disabilities and their families. Join us on Monday, October 23 at 2 p.m. Eastern Daylight Time at http://bit.ly/2xrvEQF to learn more! Presenters will include Kali Grant, GCPI; T.J. Sutcliffe, The Arc; Erika Hagensen, North Carolina; and Lauren Agoratus, New Jersey.
On September 27, the Senate passed The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act by unanimous consent. This bipartisan legislation, introduced by Senators Susan Collins (R-ME), Tammy Baldwin (D-WI), Lisa Murkowski (R-AK), and Michael Bennet (D-CO), calls for the development of a national strategy to support the nation’s more than 40 million caregivers. It would bring together stakeholders from both the public and private sector to create an advisory body. This advisory body would then develop recommendations for how government, communities, providers, employers, and others can better recognize and support family caregivers. See the statement from the lead Senate sponsors here. The next step is for the House to pass its version of the bill, H.R. 3759, out of committee. The Arc encourages advocates to ask their representative to join the list of cosponsors.
Last week, the House of Representatives voted 244 to 171 to revive a failed former policy that cuts off Supplemental Security Income (SSI) benefits for certain people with disabilities and seniors. As amended and approved by the House, H.R. 2792 would revive a failed former policy targeting SSI recipients with old, outstanding arrest warrants for alleged felonies or alleged violations of probation or parole. This former policy ended following the resolution of class action litigation. Federal law already prohibits payment of SSI benefits to people fleeing from law enforcement to avoid prosecution or imprisonment, and the Social Security Administration has a process in place to notify law enforcement of the whereabouts of such individuals. Based on experience with the former policy, H.R. 2792 would not help law enforcement to secure arrests, but instead would target people whose cases are inactive and whom law enforcement is not pursuing. Anecdotally, a very high percentage of people affected by the former policy were people with mental impairments, including people with intellectual disability. To learn more, read The Arc’s press statement condemning the House vote to advance this harmful legislation.
The Senate Budget Committee released its Fiscal Year 2018 Budget Resolution on September 29. The budget resolution (BR) is a 10-year spending and revenue blueprint for the federal government. The Senate Budget Committee’s BR contains reconciliation instructions that will allow the Finance Committee to develop tax reform legislation that increases the deficit by to $1.5 trillion over the next decade. In addition, the BR includes reserve funds for legislation to repeal or replace the Affordable Care Act, extend the State Children’s Health Insurance Program (CHIP), and ensure “state flexibility” in education, among other things. The BR is expected to be marked up in committee next week and brought to the full Senate in mid-October. The Arc is concerned that the BR will open the door for Congress to try again to limit health care and cut the Medicaid program as well as to provide large tax cuts that result in the need to cut Medicaid and other programs down the road to pay for them. Click here for the summary of the Senate budget resolution.
Last week, Senate Majority Leader Mitch McConnell (R-KY) cancelled plans to hold a vote on the Graham-Cassidy bill. With Fiscal Year (FY) 2017 having ended on September 30, Congress can no longer use that fiscal year’s budget reconciliation process to pass the bill with a simple majority vote. It now requires 60 votes. This victory would not have been possible without the disability community. Had this bill become law, it would have:
- Capped growth in per capita Medicaid spending at below the cost of providing services;
- Replaced premium tax credits and Medicaid Expansion funds with a block grant that grows more slowly than current law and expires after 2026;
- Redistributed funds away from states that accepted Medicaid expansion; and
- Allowed states to let insurers sell plans that cover fewer services and charge more based on health status or disability.
The Senate Finance Committee hearing on the Graham-Cassidy-Heller-Johnson Proposal on September 25 was marked by high attendance of disability advocates. Protesters from ADAPT started a chant of “No cuts to Medicaid, save our liberty” and their arrests delayed the start of the hearing by 15 minutes. Senator Robert Casey (D-PA) mentioned The Arc’s advocacy and showed the stack of letters with stories from our advocates across the country.
While the cancellation of the vote on the “Graham-Cassidy” bill closed the door on Congress’s best opportunity to pass this legislation for now, there are still major challenges ahead. The 115th Congress can write two more budgets, one each for FY 2018 and FY 2019. With each budget, there is an opportunity for one reconciliation bill which requires only a simple majority to pass in the Senate. The reconciliation bill for FY 2018 will most likely focus on tax cuts. It is possible that Congress will attempt to cut Medicaid, Medicare, Supplemental Security Income, or other programs that pay for basic livings needs of people with disabilities as a way to offset revenue reductions. Additionally, Congress could attempt to pass an Affordable Care Act Repeal with Medicaid per capita caps and major tax legislation in one package. In summary, fewer pathways now exist to cut program that cover basic living expenses, but threats still remain. See article above for Congressional efforts to develop a new budget resolution similar to the most recent efforts which allowed for consideration of major Medicaid cuts and repeal of the Affordable Care Act in 2017.
On October 4, the House Committee on Energy and Commerce will hold a markup on a bill to reauthorize funding for the Children’s Health Insurance (CHIP) program. This markup will come after the program’s funding expires. Some state’s programs ran out of funding on September 30. The Arc urges swift passage of legislation to continue this vital program. See the committee’s announcement for more information.