The Centers for Medicare and Medicaid Services (CMS) announced round two of the Health Care Innovation Awards. CMS will spend up to $1 billion for awards and evaluation of projects that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The second round focuses on four areas: outpatient and/or post-acute settings, populations with specialized needs, specific types of providers and suppliers, and improving the health of populations. Persons requiring long-term support and services are included in the populations with specialized needs area. Eligible applicants include: provider groups, health systems, community collaboratives, community-based organizations, payers and other private sector organizations, faith-based organizations, states, local governments, public-private partnerships and for-profit organizations. Details are available on the CMS website.
On June 5, 2013, the U.S. Department of Housing and Urban Development (HUD) issued new guidance to HUD-assisted housing providers on how they can support state and local efforts to increase the integrated housing opportunities for individuals with disabilities who are transitioning from, or at serious risk of entering, institutions and other restrictive, segregated settings. The guidance provides background information about the integration mandate under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act and the Supreme Court decision in Olmstead v. L.C. The guidance also includes a question and answer section addressing the definition of integrated setting and the role HUD agencies play in Olmstead implementation planning.
The President’s Committee for People with Intellectual Disabilities (PCPID) released its 2012 Report to The President that addresses the provision of long-term services and supports through managed care arrangements. It includes background information about the evolution of managed care and offers 15 recommendations for the federal government to pursue. The recommendations fall into four categories: disability stakeholder engagement, choice and self-determination, consumer protections and rights, and quality measurement, data collection and research.
Community Catalyst and Georgetown University’s Health Policy Institute created a Health Insurance 101 online guide on private health insurance. The guide is intended to help consumer advocates answer critical questions about private insurance: What is health insurance and how does it work? How do people get health insurance today? How will health insurance change under health care reform? Answers to questions about fully insured employer health plans, self-insured employer health plans, medical underwriting, and more are provided.
Last week, the 2013 edition of UNICEF’s The State of the World’s Children was released. This year’s publication is entitled Children with Disabilities, and examines the discrimination and deprivations that these children and their families confront. The report describes the progress that is being made, albeit unevenly, in ensuring that children with disabilities have the fair access to services and opportunities that is their right. The report also urges governments, their international partners, civil society, and employers to take concrete steps to advance the cause of inclusion – as a matter of equity and for the benefit of all. Download the PDF version of the report.
Incentives for Nondiscriminatory Wellness Programs in Group Health Plans, a rule about employer-sponsored wellness programs, was released by the Obama administration. Although research has yet to demonstrate that workplace wellness programs achieve their intended goals – reduce healthcare costs and improve employee health, employers will be permitted to reward employees who participate in wellness programs by reducing their health insurance premiums by up to 30% and up to 50% for programs that are designed to prevent or reduce smoking. Employers can penalize employees who do not participate by increasing their premiums. The rules are intended to prevent discrimination against people who cannot meet wellness targets due to their disability. Employers must provide reasonable alternatives so that employees who cannot meet health targets can still participate and be eligible for rewards.
The Social Security Trustees have released their annual report on the current and projected financial status of the Social Security trust funds. Similar to 2012, the 2013 findings show that Social Security is fully solvent until 2033, but faces a moderate long-term shortfall. In 2012, Social Security took in roughly $54 billion more than it paid out. Its reserves were $2.73 trillion in 2012, and are projected to grow to $2.9 trillion by the end of 2021. If Congress does not act before 2033, the reserves would be drawn down, and revenue coming into the Trust Funds would cover about 77 percent of scheduled benefits. The 2013 Report also continues to project that the Disability Insurance (DI) trust fund by itself can pay all scheduled benefits until 2016. If Congress takes no action before 2016, the Trustees project that the DI trust fund will be able to pay about 80 percent of scheduled benefits.
As noted by the Center on Budget and Policy Priorities and the National Academy of Social Insurance, the long-term growth in DI has been predicted since the mid-1990s and is largely due to demographic factors. The U.S. population and the number of workers insured for DI have grown; on average, Americans are living longer but with more disability; and the baby boomers are now in their high disability years.
Traditionally, Congress has reallocated payroll tax revenues between the OASI and DI trust funds to address projected shortfalls. According to the Social Security Chief Actuary, a modest reallocation of the total OASDI payroll tax, enacted prior to 2016, would allow both programs to pay full scheduled benefits through 2033 — their current combined depletion date. After that, modest increases in revenue can ensure the long-term solvency of the Social Security system for generations to come. The Arc strongly supports these types of adjustments to ensure the short- and long-term solvency of the trust funds, so that Social Security can remain a lifeline for people with disabilities and their families for generations.
On June 5th the House Committee on Ways and Means, Social Security Subcommittee will hold a hearing on Social Security’s representative payee program, focused on management challenges and the Social Security Administration’s plans for the program. At the hearing, a Government Accountability Office (GAO) report on the program, requested by the Committee, will be released. Visit the Committee website to learn more and for live video on the day of the hearing.
The Obama administration is reporting that people purchasing insurance in the individual market will have more insurance options when the private health insurance marketplaces begin operating later this year. Consumers in every state will have access to a marketplace, but each state can choose how it will operate. In 2014, 17 states (including the District of Columbia), will fully run their own marketplace. The Department of Health and Human Services (HHS) will fully run a marketplace in 19 states. In 15 states, HHS will work with the state to run a Marketplace.
HHS reports that 120 insurance companies have applied to offer insurance in the federally run marketplaces. There are also 200 applications for proposed plans to operate in multiple states. In reviewing the current health insurance landscape, the administration found that in 29 states more than 50% of all people with individual insurance are covered by one insurer. It is hoped that the increased competition will help keep with the costs down. HHS will be releasing premium information in September, once negotiations with the plans are completed. The marketplaces will begin enrolling people in October with coverage beginning in January, 2014.
The Arc and numerous advocacy organizations have launched a new campaign called “Stop Hurting Kids” with the goal of getting federal legislation passed to ensure that all students are safe in school. The campaign includes a website where people can sign up for email alerts and action items. The website has a link to a video that features first-person accounts from children and families of the physical and emotional harm suffered after being restrained and secluded in school. There is information on the website about H.R. 1893, Keeping all Students Safe Act. And finally, there are tips about how to use social media to support the campaign to keep all students safe in school.