Today the Senate will resume consideration of S. 1197, the 2014 National Defense Authorization Act. On November 19, Senators Patty Murray (D-WA) and Kirsten Gillibrand (D-NY) introduced amendment 2265 to provide access to behavioral health treatment, including applied behavioral analysis (ABA), to children and adults with developmental disabilities in TRICARE, the military’s health care system. A similar provision was passed by the House in June. Behavioral health therapy has been shown to be highly effective for children with significant developmental disabilities. TRICARE currently provides limited coverage of ABA under three different programs.
The Arc’s HealthMeet initiative, which aims to reduce health disparities among people with intellectual disabilities (ID), is launching a short, internet-based survey for family or staff who support people with ID. This survey asks questions about health status of people with ID and can also be used as a checklist to help people identify red flags about the health of the person you support. The survey takes about 15 minutes. Take the survey now. Please share with your friends, families and colleagues who provide support for people with ID.
The Department of Health and Human Services (HHS) has moved the deadline back from December 15 to December 23 for signing up for health insurance in the private marketplace for coverage beginning on January 1, 2014. The open enrollment period continues through March 31, 2014. HHS continues to work on improving the performance of the healthcare.gov website used to enroll in the plans in the states where the federal government established the marketplace.
On November 19, Senators Patty Murray (D-WA) and Kirsten Gillibrand (D-NY) introduced amendment 2265 to provide access to behavioral health treatment, including applied behavioral analysis (ABA), to children and adults with developmental disabilities in the health care system for military families (TRICARE). A similar provision was passed by the House in June. Decades of research show the effectiveness of behavioral health care for children with significant developmental disabilities to be successful in school and live independently. TRICARE currently provides limited coverage of ABA under three different programs.
On November 13, the Fiscal Year 2014 Budget Conference Committee held its second public meeting. Congressional Budget Office (CBO) director Doug Elmendorf presented on CBO’s budget and economic outlook and answered questions. Committee Members inquired about numerous budget issues including spending for entitlement programs (Social Security, Medicaid, and Medicare), investments to spur job creation, income inequality, and overall federal spending and revenues. The Committee’s recommendations are due by December 13. View the archived webcast.
Shortly afterwards, CBO released its report “Options for Reducing the Deficit: 2014-2023” which include numerous options for spending cuts and increased revenue and the estimated costs of those options. The list includes a number of options that would be harmful to people with disabilities, including eliminating Supplemental Security Income (SSI) benefits for children; reducing Social Security benefits for new beneficiaries by 15%; using an alternative measure of inflation (the “chained” consumer price index (CPI)) to index Social Security and other mandatory programs; and raising the full retirement age for Social Security.
Last Friday, the House of Representatives voted 261-157 to allow health insurers to continue to sell policies that do not meet the standards established by the Affordable Care Act (ACA) for consumer protections and comprehensive benefits. While the House has voted numerous times to repeal all or part of the ACA, this vote received more bipartisan support than previous votes. The ACA’s consumer protections included numerous provisions to prevent discrimination against people with health conditions and disabilities and to ensure fair health insurance premiums for people with health conditions. The law required health plans to provide a minimal level of benefits. The intent of these reforms was to make insurance sold in the individual and small group market more like plans offered by employers. It is not likely that the Senate will take up the legislation at this time, but several Senators have introduced similar bills. The Administration has threatened a veto.
Before the vote, the Department of Health and Human Services announced that it would allow states and insurance companies to renew plans that did not meet the new consumer protections and essential health benefit provisions for a transition period of one year. Insurers would not be allowed, as they would in the House plan, to sell new polices that do not meet the standards. The Administration announced the policy in a letter to state insurance commissions sent on Thursday, November 14th. States and insurance companies will decide if they will use this flexibility to continue to sell plans that do not meet the ACA minimal consumer protection and essential health benefit standards.
On November 15, The Arc participated in a celebratory event at the White House observing the enactment of legislation which later led to the Developmental Disabilities Assistance and Bill of Rights Act (DD Act). Speakers discussed the considerable progress made for people with disabilities since the enactment of the DD Act as well as remaining challenges. Panelists on education, employment, and long term supports and services provided overviews and offered their thoughts on improving the service delivery system. Common themes that emerged include the need to focus on people’s strengths, fully include people with disabilities in the policy process, respect the fundamental rights of people with disabilities in decision making, and the need for true integration in community living.
The Department of Education contracted with Mathematica Policy Research to examine access to effective teaching in grades 4 through 8 in 29 diverse school districts over the 2008-2009 and 2010-2011 school years. In a November 2013 report, “Access to Effective Teaching for Disadvantaged Students,” researchers concluded that on average, disadvantaged students did not have equal access to effective teaching.
Despite these findings, the Department is changing requirements for states interested in renewing their No Child Left Behind Act waivers that directly pertains to access to effective teachers. Previously, states would have been required to include plans for spending federal professional development funds and for improving the distribution of effective teachers to ensure that children who are poor or minorities are not taught by ineffective teachers at a higher rate than their peers. The Department is backing away from those requirements and, instead, plans to address them for all states, not just the waiver states, “outside the [No Child Left Behind waiver] flexibility process.” The Department’s expectation is that states will “continue to move forward with efforts to support high-quality professional development and increase equitable access to effective teachers for all students.”
The National Council on Disability released Strength in Our Differences, its annual disability policy report on the state of disability policy in the United States. The report is organized into four major issue areas: ratification of the Convention on the Rights of Persons with Disabilities (CRPD), economic empowerment, health care and access to medical treatment, and community integration. The report includes a number of recommendations designed to address barriers to inclusion and full participation in society for the President and Congress to consider.
The Obama Administration has announced that the final regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) will be published in the Federal Register this week. The law is a significant breakthrough for ensuring that large group health insurance plans that offer mental health and substance abuse coverage do not impose less favorable benefit limits than what is applied to medical or surgical coverage. This will mean that the treatment limitations or cost sharing cannot be significantly more limiting than what is applied to other medical benefits. The law applies mainly to non-Federal governmental plans with more than 100 employees and to group health plans of private employers with more than 50 employees. Disability advocates had been urging the Department of Health and Human Services to finalize these regulations to help clarify how this law will be implemented and to help define how it will interact with the Affordable Care Act (ACA). The ACA included mental health and substance abuse coverage as one of the ten essential health benefits that must be provided by plans sold in the new marketplace.