On March 20 and 21, the Senate and House respectively passed a continuing resolution (CR) that will fund the federal government for the remaining half of the fiscal year which ends on September 30. The measure level funds most programs from the CR for the first half of the year which had received a small 0.6% increase over 2012.
The measure incorporates the across-the-board cuts, known as sequestration, from the Budget Control Act (BCA). Though the across the board spending cuts are opposed by many in Congress, House and Senate leaders opted to include them in the current spending bill rather than risk a government shutdown. Taken together, the BCA’s first and second set of lowered spending caps, will result in an approximate reduction of 15% for discretionary programs from where they would have been prior to the deficit reduction law. President Obama is expected to sign the measure shortly.
Social Security/Employment/Appropriations – WIPA/PABSS Funding Reinstated
The CR passed by the House and Senate includes $27 million for the Work Incentives Planning and Assistance (WIPA) program and $7 million for the Protection and Advocacy for Beneficiaries of Social Security (PABSS) program. Since their inception, WIPA and PABSS have provided essential support to help Social Security and SSI disability beneficiaries attain self-sufficiency through work. The authorization of appropriations for the PABSS and WIPA programs expired on September 30, 2011. The Social Security Administration set aside funding to sustain the PABSS program until September 30, 2012 and the WIPA program until June 30, 2012, but did not continue to fund the programs after those dates. Funding under the CR will allow the restarting of the programs.
Budget – House and Senate Pass Fiscal Year 2014 Budget Resolutions
The House and Senate passed starkly different blueprints for federal spending and revenue for the next decade. The major provisions in the budgets that are most relevant to the disability community are:
||Block grants Medicaid and cuts spending by $810 billion
||$10 billion in Medicaid cuts with the caveat that none of those cuts can affect beneficiaries
||Turns Medicare into a voucher program and has steep cuts in Medicare payments to doctors
||$265 billion in Medicare cuts
|Social Security and SSI
||Social Security not cut, but the President and Congress will be required to develop plans to ensure it remains solvent. $300 billion cut from the income security portion of the budget which includes Supplemental Security Income (SSI)
|Non-Defense Discretionary Programs
||$3.8 trillion cut beyond the across-the-board spending cuts
||Replaces the across-the-board spending cuts with $493 billion in domestic spending cuts, in addition to specific cuts above
An unusually large number of amendmentswere filed to the Democratic Senate Budget, though most were not voted on. Among these were several relevant to the disability community:
- Casey amendment to include the ABLE Act (filed but not voted on).
- Sanders-Harkin-Hirono amendment to express opposition to the chained CPI measure of inflation (agreed to by voice vote).
- Roberts amendment to increase funding for Individuals with Disabilities Education Act while cutting untested educational programs (filed but not voted on).
- Roberts amendment prohibiting the HHS Secretary from using funds for implementation of health benefit exchanges until it is certified that the Affordable Care Act has resulted in reduction in average health insurance premiums by $2500 (filed but not voted on).
- Cardin amendment to improve oral health care for children with Medicaid coverage (agreed to by voice vote).
- Hatch amendment to repeal the Affordable Care Act’s individual mandate to obtain health insurance (filed but not voted on).
- Risch amendment for replacing Medicaid and Children’s Health Insurance program with a block grant to the States (filed but not voted on).
In addition, there was an important amendment relevant to the non-profit community:
Social Security – House Holds Hearing on Social Security Disability Decisions
On March 20th the House Committee on Ways and Means, Social Security Subcommittee held a hearing on “Challenges of Achieving Fair and Consistent Disability Decisions.” Witnesses were Patrick P. O’Carroll, Jr., Inspector General, Social Security Administration (SSA), accompanied by Heather Hermann, National Coordinator, Cooperative Disability Investigations Program, Office of the Inspector General, SSA; Arthur R. Spencer, Associate Commissioner, Office of Disability Programs, SSA; Kathy Ruffing, Senior Fellow, Center on Budget and Policy Priorities; Trudy Lyon-Hart, Director, Office of Disability Determination Services, Vermont Agency of Human Services, on behalf of the National Council of Disability Determination Directors; David Hatfield, Administrative Law Judge (Retired), Wexford, Pennsylvania. Visit the Committee web site to review testimony and archived video of the hearing.
Civil Rights/Transportation – Senator Harkin Introduces Legislation to Expand Captioning and Improve Access to Movies
Senator Tom Harkin (D-IA), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), has introduced two bills that will expand access to captioning and image narration in movie theaters and airplanes.
The Captioning and Image Narration to Enhance Movie Accessibility (CINEMA) Act would amend Title III of the ADA to require movie theater complexes of two or more theaters to make captioning and video description available for all films at all showings. Video description is a process that allows an individual who is blind or visually impaired to have access to the key visual elements of the programming by contemporaneous audio narrated descriptions of the actions, settings, facial expressions, costumes, and scene changes during the natural pauses in the audio portion of the programming, usually through headphones.
The Air Carrier Access Amendments Act would amend the Air Carriers Access Act to require that air carriers make captioning and video description available for visually-displayed entertainment programming – live televised events, recorded programming, and motion pictures—that is available in-flight for passengers. In instances where the programming is only available through the use of an individual touchscreen or other contact-sensitive controls, the bill would authorize the U.S. Access Board to promulgate accessibility standards so that individuals with disabilities, including individuals who are blind or visually impaired, can operate the displays independently.
Major Events Ahead
Social Security – Webinar on Cuts from the Chained CPI & People with Disabilities, March 27th, 2:00 pm
As Congress continues to look at deficit reduction, a major cut called the “chained CPI” is on the table. The chained CPI would cut Social Security, Supplemental Security Income (SSI), and other vital benefits. Cuts from the chained CPI would add up significantly over time and would disproportionately harm people with disabilities. The Arc recently released a National Policy Matterson the chained CPI. On Wednesday March 27, 2013, from 2:00 – 2:45 p.m. EDT join the Consortium for Citizens with Disabilities Social Security Task Force for a webinar to learn more about:
- What is the chained CPI?
- How would the chained CPI harm people with disabilities and their families?
- What can you do to help keep the chained CPI from becoming a reality?
To register: https://www2.gotomeeting.com/register/413501170. For more information: T.J. Sutcliffe, The Arc / CCD Social Security Task Force Co-Chair at firstname.lastname@example.org / 202-783-2229 or Rebecca Vallas, Community Legal Services / CCD Social Security Task Force Co-Chair at email@example.com / 215-981-3797.
Budget – Further Deficit Reduction Efforts Hinge on Compromises on Entitlement Spending and Revenue
Further deficit reduction negotiations will depend largely on Congress’ ability to negotiate a compromise on the priorities laid out in the House and Senate Budget Resolutions. Presently, they are very far apart on the fundamental issue of the role and size of the federal government. This is reflected in the great divide on the two key issues of entitlement programs (Medicaid, Medicare, Social Security, and SSI) and revenue (personal and corporate taxes). Any plan negotiated to further reduce our deficits will have a tremendous impact on the future of all federal programs that are critical to the health and wellbeing of people with disabilities in the FY 2014 appropriations and beyond. These issues are next expected to come to a head this summer with the required vote to increase the debt ceiling.
Immigration/Direct Support Workforce – Webinar on Immigration Reform Issues for People With Disabilities and Older Adults
As Congress considers comprehensive immigration reform, it is important for the aging and disability communities to be engaged on this issue. Immigration reform provides opportunities to strengthen the direct care workforce and address the projected shortage of workers as the baby boom generation ages and more individuals need long-term services and supports. In addition, immigration reform can help eliminate discrimination against older immigrants and those with disabilities. The webinar will be held on Thursday, April 4, 2013 at 2:00 – 3:30 pm Eastern Daylight Time. It is being hosted by a coalition of national aging and disability organizations working together to advance home and community-based services and supports. Space is limited, so please register early and share lines when possible. To register, please go to the following link: https://cc.readytalk.com/r/7yp0nq6mkqlk
Medicaid – NCD Recommends Ways to Implement Medicaid Managed Care without Harming People with Disabilities
Last week, The National Council on Disability (NCD), an independent federal agency tasked with providing advice to the President and Congress on policy matters affecting the lives of people with disabilities, released a report titled “Medicaid Managed Care for People with Disabilities: Policy and Implementation Considerations for State and Federal Policymakers.”
More than two-thirds of the 70 million Medicaid beneficiaries receive at least a portion of their services through a managed care plan. Until recently, the vast majority of these enrollees have been people without disabilities, however, now more than half of states are enrolling adults and children with disabilities. In addition, the number of States utilizing Medicaid managed care for long-term services and supports jumped from 8 in 2004 to 16 in 2012. This trend will undoubtedly increase as the Affordable Care Act expands Medicaid eligibility in 2014. Against this backdrop, NCD’s report examines the implications, benefits, necessary principles, and operational features of Medicaid managed care for people with disabilities, and advances recommendations for state and federal policymakers. NCD’s report is based on 22 guiding principles developed by NCD to assist in the design and implementation of managed care for people with disabilities. NCD recommends in the report that these principles be rigorously applied in designing and operating managed care services.
The full report, including the guiding principles and specific recommendations developed by NCD, are available online at: