On September 13, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) introduced their most recent version of legislation to replace the Affordable Care Act and cap Medicaid. The bill eliminates the Affordable Care Act’s premium tax credits, cost-sharing subsidies, and Medicaid expansion and replaces them with a block grant. The block grant represents a 17% cut in funding by 2026 compared to current law. This block grant will only be funded until December 31, 2026. Like previous proposals, this bill also allows states to weaken consumer protections such as the ban on pre-existing condition exclusions and the essential health benefits requirement. Finally, it includes the per capita caps on the traditional Medicaid program as seen in the Better Care Reconciliation Act. The Congressional Budget Office is developing a cost estimate on the bill in preparation for possible Senate floor action next week.
This summer – advocates helped defeat a dangerous health care bill that would have included massive cuts to Medicaid. We need your help to reinforce this message once again, as proposals such as the Graham, Cassidy, Heller, and Johnson bill include threats that are just as damaging to people with disabilities and their families.
The newest version of the Graham-Cassidy-Heller-Johnson Health Care bill (see article below) may be on a fast track for a Senate vote before the authority for passage by a simple majority under the budget reconciliation instructions expires on September 30. Reports from the Senate indicate that Senators Graham (R-SC) and Cassidy (R-LA) have nearly the 50 votes needed for the bill to trigger a tie-breaking vote by Vice-President Mike Pence for passage. If successful, expectations are that the bill would go immediately to the House floor for passage and then to the President for signature. This would be a devastating blow to people with disabilities and their families who have worked so hard this year to prevent block grants and per capita caps from destroying the Medicaid program – a program which provides basic health care and long term supports which make it possible for millions of people to live as independently as possible in their home communities.
Recently, Colorado, Indiana, and New York opened qualified ABLE programs, bringing the total number of jurisdictions with ABLE programs to 29.
Colorado and Indiana’s ABLE programs are open to all eligible individuals nation-wide. They have six investment options and a checking option with a debit card. The accounts have a quarterly fee of $15, which is reduced by $3.75 for individuals who elected to receive their statements electronically. Additionally, they have asset-based fees ranging from 0.34% to 0.38% depending on the investment options chosen.
New York‘s ABLE Program is currently only open to state residents. It has four investment options and a checking account with a debit card. Accounts have a quarterly fee of $11.25 for account-holders who receive electronic statements and $13.75 for account-holders who receive paper statements. Additionally, there is a 0.4% asset-based fee on investment options.
More information about state implementation of the ABLE Act can be found here. General information about ABLE programs can be found in the National Policy Matters: ABLE Accounts for People with Disabilities here.
On September 7, the House Judiciary Committee approved the ADA Education and Reform Act of 2017 (H.R.620) by a vote of 15-9. This bill prevents lawsuits over architectural barriers violating the Americans with Disabilities Act (ADA) unless an individual provides “specific enough” notice and allows 120 days for a business to correct that barrier. The bill was introduced on the belief that the ADA has led to “frivolous lawsuits” where plaintiffs and attorneys intentionally seek barriers in order to extract funds. However, the ADA does not allow courts to award monetary damages to plaintiffs. Where those damages are available, it is through state law. Furthermore, there are already laws on the books that allow punishment of attorneys who represent clients in frivolous lawsuits. This bill effectively eliminates incentives for businesses to comply with federal law until 120 days after a person with a disability asks them to do so. See this fact sheet from Disability Rights Education & Defense Fund for more information.
Last week, The Arc and the Georgetown Center on Poverty and Inequality released a first of its kind paper outlining why paid family and medical leave is a necessity for the economic security and stability of people with disabilities and their families.
The Arc also released a video featuring one family’s paid leave story, and a set of stories profiling several workers whose paid leave stories highlight the disability perspective.
Learn more at: http://www.thearc.org/paidleave.
On September 6, the House Committee on Ways and Means Social Security Subcommittee held a hearing on “Determining Eligibility for Disability Benefits: Challenges Facing the Social Security Administration.” Witnesses were Bea Disman, Acting Chief of Staff, Social Security Administration; Kathryn Larin, Director of Education, Workforce, and Income Security Issues, Government Accountability Office; Elizabeth McLaren, Bureau Chief, Iowa Disability Determination Services on behalf of National Council of Disability Determination Directors; Marilyn Zahm, President, Association of Administrative Law Judges; and Lisa Ekman, Director of Government Affairs, National Organization of Social Security Claimants’ Representatives on behalf of the Consortium for Citizens with Disabilities Social Security Task Force. Visit the committee web site to review testimony and archived video of the hearing.
On September 7 and 8, the Senate and House voted, respectively, to pass a continuing resolution (CR), H.R. 601, to fund the federal government through December 8. The measure, which also includes an increase in the debt ceiling and $15.25 billion in funding for hurricane relief through the same date, was signed by President Trump on September 8. This short-term measure was needed because none of the 12 annual appropriations bills have been passed by the House and Senate, leaving little time before the end of the 2017 fiscal year on September 30. The CR provides for level funding for existing federal programs. The House and Senate will need to negotiate differences between their spending bills and pass the them before December 8 or face a shutdown or an additional CR. To date, the chambers are far apart on their funding levels, including the overall funding for the Departments of Labor, Health and Human Services, and Education (L-HHS-ED) which funds the vast majority of disability-related programs. See current funding levels for disability-related programs approved by the House and Senate Appropriations Committees here.
The Administration continues to urge the Senate to return to efforts to repeal and replace the Affordable Care Act (ACA). Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) are promoting a bill they cosponsored which includes a Medicaid per capita cap and block grant of the Medicaid expansion funding and the market place subsidies. While their proposal may be revised, The Arc is especially concerned about the proposed cut and caps to Medicaid. Based on a recent opinion by the Senate Parliamentarian, the Senate can return to debate on health care any time before the special budget reconciliation rules for fiscal year 2017 expire on September 30; maintaining the protection of needing only a simple majority to pass the legislation until that date.
The Senate is involved in a number of efforts to address health care issues in a bipartisan manner. The Senate Health Education Labor and Pensions (HELP) Committee, under the leadership of Chairman Lamar Alexander (R-TN) began holding four hearings last week and will continue this week on ideas to stabilize the individual insurance marketplaces. His intent is to reach bi-partisan agreement on a narrow time limited proposal that could be passed by the end of the month. While legislation has not been drafted, the Committee is considering ensuring that funding is appropriated for cost sharing reduction payments that help low income people afford insurance and changes to the existing waiver program that allows states to create marketplaces that do not meet the requirements of the ACA.
The Senate Finance Committee held a hearing on the Children’s Health Insurance Program (CHIP) for which federal funding will expire this year. CHIP was created in 1997 and has strong bi-partisan support. States can create a separate program for children, expand Medicaid, or some combination of both. CHIP has been very successful at expanding insurance coverage for children. The Arc urges Congress to renew funding for CHIP as soon as possible so that states can continue their programs without interruption.
The ABLE National Resource Center (ANRC) has declared August as #ABLEtoSave month. During this month, the center will be raising awareness and providing resources relating to ABLE programs. Additionally, they are hosting a series of webinars:
- Week 1 (July 30 – August 5): Basic Overview of ABLE
- Week 2 (August 6 -12): Eligibility
- Wednesday August 9, from 2:00 – 3:00 EDT
- Week 3 (August 13 – 19): Qualified Disability Expenses
- Week 4 (August 20 – 26): Financial Literacy
- Week 5 (August 27 – September 2): Enrollment
To learn more about the #ABLEtoSave campaign and ABLE accounts, visit the ANRC website and be sure to “like” the ANRC on Facebook and Twitter (@theABLENRC).