The Arc at the Table with President Obama to Discuss Tax Cuts for the Middle Class, Budget and Medicaid

Last week, The Arc’s CEO Peter Berns participated in a small meeting with President Barack Obama, Vice President Joe Biden, and senior economic advisors about the President’s goal to stop middle class tax increases and to raise revenues to help invest in the nation and reduce the deficit.  The discussion centered on the urgency of passing a plan to avert raising taxes on the middle class and to raise revenues to finance the federal government without allowing drastic cuts to programs that people with intellectual and developmental disabilities (I/DD) and other vulnerable groups rely on, like education, housing, and employment.  These cuts are scheduled to take place on January 1, 2013, along with the expiration of a variety of tax provisions. To read more visit our blog.

House passes short term FY 2013 Continuing Resolution

On September 13, the House of Representatives passed (H J Res 117), a “clean” six-month stopgap spending bill. The Senate is expected to complete action on the measure this week. The Continuing Resolution (CR) would fund the government through March 27 and increase spending by 0.6% for most federal programs and agencies. The bill incorporates the $1.047 trillion discretionary spending level set in the Budget Control Act of 2011 (PL 112-25) rather than the lower $1.028 trillion level desired by the House. Most disability-related programs would receive the small 0.6% increase over the amount they received in 2012 (Visit The Arc’s website to see the FY 2012 funding levels). Of note, the CR also includes an extension of the highly qualified teacher amendment (HQT amendment) for just one year rather than two. Under the HTQ amendment, teachers who are participating in alternative teacher preparation programs and are still in training can be called highly qualified. These teachers are disproportionately assigned to students with disabilities and other vulnerable groups. The CR also includes a requirement that the Secretary of Education submit a report to Congress that includes information on the number of students with disabilities that are taught by teachers who are deemed highly qualified.

Major Victory for People with Disabilities; U.S. Supreme Court Rules ACA is Constitutional

In a major victory for people with disabilities and their families, the United States Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). In brief, the Court ruled that the penalties an individual would pay for not buying health insurance (referred to as the individual mandate) are constitutional under the Congress’s power to tax. This decision means that the critical health insurance reform provisions eliminating discriminatory practices such as pre-existing condition clauses, the practice of charging significantly higher premiums because of a person’s medical condition, and other practices will either remain in effect or be allowed to take effect as scheduled in 2014.

The Supreme Court also ruled that states can opt out of the health care law’s Medicaid expansion without losing federal funding for its entire Medicaid program. The Arc is concerned that disallowing the federal government’s ability to withhold Medicaid dollars from states that do not expand Medicaid to cover more of the uninsured might mean that people with I/DD who would have benefitted from the expansion could be left behind. Medicaid is an incredibly important lifeline for people with I/DD, providing health care and long term services and supports. State advocates will need to make the case that the federal government paying 100% for the first 2 years and phasing down to 90% in 2020 is a good deal for states. The Medicaid decision does not affect any of the other improvements to Medicaid’s long term services policies that were passed as a part of the ACA.

The Arc will prepare an updated explanation/discussion of the provisions of the Affordable Care Act that will benefit people with disabilities, including expected effective dates. We will continue to work on implementation issues as the Administration issues proposed regulations to implement various provisions of the law. To view The Arc’s statement visit our blog.

House Passes FY 2013 Ryan Budget

As expected, on March 29, the House voted to pass the Fiscal Year 2013 Budget Resolution. The measure passed by a vote of 228-191. This plan for federal spending and revenue would be very harmful for people with disabilities as mandatory programs that people with disabilities rely on (Medicaid, Medicare) would be significantly cut and/or restructured, funding for critical discretionary programs (such as housing, education, employment, and transportation) would be slashed, and the health care reform law would be repealed. Specifically:

  • Medicaid would be cut by $810 billion over 10 years (a 33% cut by 2021), converted to a block grant, and all “dual eligibles” would be placed entirely in the Medicare program.
  • Medicare would be converted to a “premium support program” by offering vouchers to purchase private insurance or the traditional Medicare program starting in FY 2023 for new beneficiaries. This would end the Medicare guarantee and raise health care costs for people with disabilities and seniors.
  • Non-defense discretionary programs would be cut by $800 billion below the amount of the automatic spending cuts from the Budget Control Act (an approximate cut of 9%).
  • Social Security reforms to provide solvency over the next 75 years would be considered under an expedited Congressional process, as opposed to normal deliberation.

Several alternatives to the FY 2013 House Budget Resolution introduced as amendments were defeated. These included the more austere plan developed by the Republican Study Committee that contained even steeper cuts in spending and a plan developed by the House Progressive Caucus which called for more investments in spending and raising revenue to help reduce the deficit.

The Senate, however, is not likely to vote on a FY 2013 Budget Resolution because the Budget Control Act already set spending caps for FY 2012 to 2021. Therefore, with different target levels set for spending, House and Senate differences may not be resolved until after a post-election “lame duck” session of Congress is convened.

House Republican Fiscal Year 2013 Budget Request Released; Would Be Very Harmful to People with Disabilities

On March 20, House Budget Chairman Paul Ryan (R-WI) released his Fiscal Year 2013 Budget Resolution, a blueprint for spending and tax policy. The release of the “Ryan budget” is the first Congressional step in what is sure to be a lengthy, partisan battle over appropriations levels, tax policy, and deficit reduction.   This plan would cut nondefense spending by $5.3 trillion over 10 years, while cutting taxes for corporations and upper income individuals. It would be very harmful for people with disabilities as mandatory programs that people with disabilities rely on (Medicaid, Medicare) would be significantly cut and/or restructured, funding for critical discretionary programs (such as housing, education, employment, & transportation) would be slashed, and the health care reform law would be repealed. Specifically:

  • Medicaid would be cut by $810 billion over 10 years (a 33% cut), converted to a block grant, and all “dual eligibles” would be placed entirely in the Medicare program.
  • Medicare would be converted to a “premium support program” by offering vouchers to purchase private insurance or the traditional Medicare program starting in FY 2023 for new beneficiaries. This would end the Medicare guarantee and raise health care costs for people with disabilities and seniors.
  • Non-Defense Discretionary programs would be cut by $800 billion below the amount of the automatic spending cuts from the Budget Control Act (an approximate cut of 9%).
  • Social Security reforms to provide solvency over the next 75 years would be considered under an expedited Congressional process, as opposed to normal deliberation.

The following day, the House Budget Committee narrowly passed a fairly clean version of the Ryan Budget and the full House of Representatives is scheduled to vote on it this week. The Senate, however, is not likely to vote on a FY 2013 Budget as the Budget Control Act already set spending caps for FY 2012 to 2021.

It is doubtful that federal funding issues, including the automatic spending cuts scheduled to take effect in January 2013, will be resolved before the November election.  If not, then Congress could reconvene in a post-election “lame duck” session to try and resolve the issues and any other outstanding matters.

U.S. Supreme Court Hears Arguments in Landmark Affordable Care Act Case

The U.S. Supreme Court will hear arguments on four issues in the consolidated cases on the Affordable Care Act (ACA) being heard this week from March 26 – 28. The questions are:

  1. Whether Congress had the power to enact the minimum health insurance coverage provision, or individual mandate to have coverage.
  2. Whether that provision is severable from the remainder of the ACA if the minimum coverage provision is found unconstitutional. (In other words, is it possible to remove this provision without making the entire law unworkable?)
  3. Whether the ACA’s requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive.
  4. Whether the minimum coverage provision is a tax for the purposes of the Anti-Injunction Act (if it is a tax, then plaintiffs seeking to challenge the provision cannot do so until it goes into effect in 2014).

The Court will hear oral arguments on the Anti-Injunction Act issues on Monday morning (3/26); on the minimum coverage issue on Tuesday morning (3/27); on the severability issue on Wednesday (3/28) morning, and on the Medicaid issue on Wednesday afternoon.

The Arc participated in two amicus curiae (“friend of the court”) briefs in support of the constitutionality of the ACA. The Supreme Court allowed organizations to participate in up to one amicusbrief per each of the four questions that the Court is considering. The Arc participated in briefs in the following cases/issues:

Department of Health and Human Services, et al, v. Florida
Minimum Coverage (Individual Mandate) Issue: The Arc joined several other advocacy and consumer organizations in filing a brief that supports the ACA’s requirement for individuals to purchase health insurance. The brief argues that a law requiring health insurers to cover people with pre-existing conditions cannot function unless it also requires nearly everyone to carry insurance.   This is because, if allowed, people will delay the purchase of insurance until they need expensive care, thereby draining the insurance plan of funds without individuals paying their share. This behavior is known as “adverse selection”.  Seven states have already tried to enact a pre-existing conditions law without a minimum coverage requirement and all seven states saw skyrocketing premiums or worse. Meanwhile, Massachusetts, the one state to enact both pre-existing conditions coverage as well as minimum coverage, saw its premiums go down 40 percent.

Florida, et al, v. Department of Health and Human Services
Expansion of Medicaid Coverage Issue: The Arc joined several other advocacy and consumer organizations in filing a brief that supports the ACA’s expansion of Medicaid coverage. The brief argues that the ACA’s Medicaid expansion is a valid exercise of Congress’ authority to enact legislation under the Constitution’s “Spending Clause,” which empowers Congress to offer money to the states with strings attached. The amicus brief addresses the potential impact of a finding of unconstitutionality on the Medicaid program as well as on other programs in which states similarly receive federal funds in exchange for complying with federal requirements.

Audio Recordings Available: Because of the extraordinary public interest in this case, the Court will provide the audio recordings and transcripts of the oral arguments on an expedited basis through the Court’s website. The audio recordings and transcripts of the March 26-28 morning sessions should be available no later than 2 p.m. on the day of the discussion. The recording and transcript of the March 28 afternoon session should be available no later than 4 p.m. that day. The Court’s website currently provides links to the orders, briefs, and other information about the case.

President Obama’s 2013 budget request provides mostly level funding for disability-related programs, with a few cuts and increases

On February 13, President Obama released his spending and revenue plan for the fiscal year starting on October 1, 2012. The Section 811 Supportive Housing for People with Disabilities program experienced the largest percentage cut with a 10% reduction from FY 2012. The Individuals with Disabilities Education Act (IDEA) Early Intervention Part C program, on the other hand, received one of the largest increases. Visit The Arc’s website to see how disability-related programs fared in the President’s Budget.

The President’s budget reflects the Administration’s priorities and is the starting point for the annual budget process. The Republican controlled House of Representatives is expected to issue its own budget blueprint in the coming weeks. However, final spending bills may be largely determined by possible Congressional action to change the automatic spending cuts scheduled to take place in January of 2013. The President’s budget offers a replacement for these automatic spending cuts required by the Budget Control Act, which as enacted, would cause disability-related and other non-defense discretionary programs to be cut by about 9%.

Congress approves full-year extension of payroll tax holiday, extended unemployment benefits, and extended Medicare physician payment rates

Congress approved legislation (H.R. 3630) to extend for the rest of 2012 the temporary payroll tax rate reduction for workers, current Medicare reimbursement rates for doctors, and some long-term unemployment insurance benefits. The legislation extends through December 31, 2012 the 2 percent reduction in the Social Security payroll tax rate for workers that was initiated as economic stimulus in 2011. It also extends current Medicare physician payment rates, avoiding a scheduled 27.4 percent cut in reimbursements. It extends certain unemployment insurance benefits for long-term jobless workers, but also reduces the maximum number of weeks of long-term benefits to 73 weeks from 99 weeks. Benefits in states with jobless rates below 9 percent would be capped at 63 weeks. The reduction would be phased in between May and September, 2012. Finally, the legislation extends Temporary Assistance for Needy Families (TANF) through September 30, 2012.

President Obama Tells The Arc, Disability Community “I’ve Got Your Back”

Last week, 150 leaders of The Arc from across the country met with a variety of senior White House officials at a Community Leaders Briefing to ask questions and discuss issues facing people with intellectual and developmental disabilities (I/DD). The session, held just for The Arc, included an unannounced visit from President Barack Obama. The President spoke of his commitment to people with disabilities saying, “I’ve got your back.” To watch President Obama’s remarks visit the White House YouTube page.

Another unannounced speaker was White House Chief of Staff Jack Lew, who reiterated the President’s opposition to turning Medicaid into a block grant.

The day was organized by Kareem Dale, Special Assistant to the President for Disability Policy, who kicked off the agenda by welcoming guests and speaking about employment issues. The Arc heard from Cecilia Muñoz, Director of the White House Domestic Policy Council, who spoke of their commitment to providing services and supports to all in need. Other speakers included Carol Galante, Acting Assistant Secretary – Federal Housing Administration Commissioner, Department of Housing and Urban Development; Cindy Mann, Deputy Administrator, Centers for Medicare and Medicaid Services; Robert Gordon, Executive Associate Director, Office of Management and Budget; and Tom Perez, Assistant Attorney General for Civil Rights, Department of Justice.

This April, there will be additional opportunities to engage with disability policy experts in Washington, DC during the 2012 Disability Policy Seminar. Come together with other advocates, learn about the issues, and speak with your elected officials about what is important to you. Take advantage of special early registration and hotel rates available until March 20.

President releases 2013 Budget Request today

President Obama unveiled his spending and revenue plan for the fiscal year starting on October 1, 2012.   The President’s Budget offers a replacement for the automatic spending cuts required by the Budget Control Act enacted last summer. It proposes to reduce the debt by about $4 trillion over 10 years, through tax increases and other savings previously proposed by the Administration. The President also recommends other targeted spending increases, including hundreds of billions of dollars for infrastructure projects and job creation.   If adopted in full, the President’s budget would make the automatic cuts (known as a sequester) slated to take effect in January of 2013 unnecessary, according to an Administration official. The automatic cuts would cause disability-related and other non-defense discretionary programs to be cut by about 9% in 2013.
The President is proposing $51 billion in Medicaid cuts over the next ten years. The cuts appear similar to previously proposed Medicaid reductions including reducing the Medicaid provider tax threshold, proposing a single blended matching rate for Medicaid and the Children’s Health Insurance program, reducing reimbursement rates for durable medical equipment and changes to the funding for hospitals that serve a large number of low income individuals. The HHS budget statement reiterated the Administration’s opposition to block granting and slashing the funding for Medicaid.
The Arc is reviewing the President’s Budget for funding requests for specific disability-related programs which we will make available shortly.