Don’t Let the Government Shut Down
Major Events Last Week
Budget & Appropriations – Debt Ceiling Determined to Be Reached On October 17
Last week, Treasury Secretary Jack Lew issued a letter stating that the U.S. will not be able to
meet its financial obligations after October 17 unless the debt ceiling limit is raised. The letter
increases pressure on Congress to pass a bill raising the statutory borrowing authority above the
current $16.7 trillion limit. Congressional Democrats and President Barack Obama have vowed not
to negotiate other funding and tax issues as part of any proposal to raise the debt ceiling. House
Republicans, meanwhile, have been discussing a number of provisions to attach to a debt-ceiling hike,
including a one-year delay of the ACA’s requirement that individuals purchase health insurance or pay
a fine and cuts to Medicaid, and Medicare. Though no bill has yet been made available, details of
the House plan were leaked to the press last week and provide insight about
where the House leadership would like to begin the discussion about raising the debt
Autism/Medicaid – Florida Appeals Court Rules Medicaid Agency Must Cover
Applied Behavioral Analysis (ABA) Therapy When Medically Necessary for Children
On September 20, a federal appeals court upheld an order directing Florida to cover applied behavior
analysis (ABA) under its Medicaid program, rejecting claims the therapy is “experimental.” The case was
brought on behalf of three children diagnosed with autism against the Florida Agency for Health Care
Administration (AHCA), which administers the state’s Medicaid program. The plaintiffs had sued the state
in 2011, contesting its blanket denial of ABA coverage. “This case will have national impact because,
while most states mandate that private insurance companies must cover ABA, most Medicaid programs
do not provide coverage,” said Miriam Harmatz of Florida Legal Services, lead counsel for the plaintiffs.
The appeals court, however, did remand the case to clarify that AHCA retains the authority to determine
the medical necessity for ABA coverage on a case-by-case basis. Read more at governing.com.
Major Events This Week/Ahead
Budget & Appropriations/Health Care – Government Shutdown Appears Increasingly Likely
Fiscal year (FY) 2014 begins on October 1, and there is no agreement in sight to keep the government open.
The Senate and House are refusing to give ground as they trade proposals. Over the weekend, the House
stuck with its plan to derail implementation of the Affordable Care Act (ACA) by sending a continuing resolution
(H J Res 59) to the Senate that would delay the law for a year and also repeal the medical devices tax that
partly funds it. The House kept the $986 billion annualized spending level proposed (the amount that
reflects the automatic, across the boardspending cuts enacted earlier this year) in the short term spending plan,
but did change the expiration day to Dec. 15 from the Nov. 15 date set by the Senate. When the Senate
returns this afternoon, it is expected to reject the ACA amendments and again send a “clean” stopgap spending
plan to the House. In the meantime, federal agencies are starting to make available their contingency plans for
a government shutdown. Learn more at the Washington Post.
Last week, The Arc sent a letter to all Members of Congress expressing our strong support for the ACA.
We describe the many benefits and protections for people with disabilities in the health insurance market,
as well as the current status of improvements in long term services and supports across the states.
Read our letter at The Arc’s website.
Health Care – Affordable Care Act’s Marketplaces Begin Enrolling October 1
The new health insurance marketplaces created by the Affordable Care Act (ACA) will begin enrolling people
on October 1st. People who do not have health insurance can purchase private health insurance in the
marketplaces. The initial open enrollment is for six months, with coverage beginning on January 1, 2014 for
those who sign up in time. When individuals apply they will learn whether they qualify for subsidies to make the
policies more affordable. Low and moderate income people with incomes less than 400% of the federal
poverty level ($45,960 for an individual and $94,200 for a family of four) are eligible for premium tax credits.
For people who have questions, the marketplace consumer call center is open 24 hours a day, 7 days a week
at 1-800-318-2596 (hearing impaired callers using TTY/TDD can dial 1-855-889-4325), with translation services
available in 150 languages. Visit HealthCare.gov or CuidadodeSalud.gov to learn more or participate in a
live chat with a trained customer service provider. Individuals will still be able to enroll in the marketplaces
even if the federal government shuts down.
The ACA also created a new health insurance marketplace for small businesses looking to provide health insurance
coverage (known as the SHOP exchange). The Administration announced last week that that there would be a
delay in the operation of the online enrollment for the federally run SHOP exchanges. Small businesses will still
be able to submit a paper application on Oct. 1 – they just won’t be able to enroll online. States that are running
their own marketplaces are not affected by this delay. The SHOP exchanges are open year-round and do not have
a time limited enrollment period.
The Arc Job Posting – Criminal Justice Fellow , National Center on Justice and Intellectual and
The Arc is seeking an energetic, entrepreneurial and self-motivated person to participate in the start-up of a
new National Center on Justice and Intellectual and Developmental Disability. Recent law school graduate with
an interest in supporting the rights of victims, defendants/offenders and witnesses with intellectual and/or
developmental disabilities (I/DD) needed to establish online resource center, training, technical assistance and
consulting services for criminal justice professionals (e.g. law enforcement, prosecuting and defense attorneys,
judicial and court personnel, victims assistance organizations, corrections personnel and expert witnesses) and
to provide programs services and supports for people with I/DD and their families.
To view the full job posting, visit The Arc’s website.
Health Care – New Resources Available on The Arc’s Website
The Arc wants to make sure you have the most up to date resources and information about the Affordable Care Act
(ACA). We have been updating our Health Care page on our website, and are excited to announce a new toolkit
that will help educate individuals about the benefits of the ACA and how to support outreach and enrollment.
Health Care – New Affordable Care Act Resource from ASAN
As implementation of the Affordable Care Act (ACA) continues, many in the disability community have questions about
how the ACA will impact them. Thanks to the generous support of the Special Hope Foundation, Autistic Self
Advocacy Network (ASAN) has produced a new policy brief that aims to answer many questions individuals in the
disability community may have. The Affordable Care Act and the I/DD Community: An Overview of the Law and
Advocacy Priorities Going Forward, provides a summary of relevant provisions of the ACA and analyzes opportunities
for advocates to enhance the impact of the law’s implementation for people with intellectual and developmental disabilities.