Capitol Insider
for the Week of November 11, 2013
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Action Alert:

The Arc Action Alert: Call-in Day for The Disability Treaty!

Major Events This Week

Health Care – Mental Health Parity Regulations to be Published This Week

The Obama Administration has announced that the final regulations implementing the Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) will be published
in the Federal Register this week.  The law is a significant breakthrough for ensuring that large group
health insurance plans that offer mental health and substance abuse coverage do not impose less
favorable benefit limits than what is applied to medical or surgical coverage.  This will mean that the
treatment limitations or cost sharing cannot be significantly more limiting than what is applied to other
medical benefits.  The law applies mainly to non-Federal governmental plans with more than 100
employees and to group health plans of private employers with more than 50 employees.  Disability
advocates had been urging the Department of Health and Human Services to finalize these regulations
to help clarify how this law will be implemented and to help define how it will interact with the Affordable
Care Act (ACA). The ACA included mental health and substance abuse coverage as one of the ten
essential health benefits that must be provided by plans sold in the new marketplace.

Major Events Last Week

Health Care – Affordable Care Act Implementation Hearings Continue

Two weeks ago, Health and Human Services (HHS) Secretary Kathleen Sebelius and Centers on
Medicare and Medicaid (CMS) Administrator Marilyn Tavenner testified before the relevant House
Committees on implementation problems with the Affordable Care Act (ACA) and last week the
Senate Committees held hearings.   In addition to the website problems, the Administration was
asked about people who are receiving cancellation notices from their health insurance providers.
It is important to understand some of the background information about why people might be getting
these notices.  Under current law, health insurance plans sold to individuals (as opposed to employers
providing health insurance) are often sold in 12 month contracts at the end of which the insurance
company has the option to discontinue or change the policy by raising premiums, increasing cost-sharing
or limiting benefits.  If they discontinue the policy they must provide 90-day notice, must offer the
policyholder another new policy as an alternative and they must treat every policy holder the same.
This has not been changed by the ACA.   About 5% of the population receives coverage in the individual
insurance market.  It is not known how many people are receiving these notices.
What the ACA has changed is that new health insurance plans sold in the individual market must meet
new consumer protections such as not raising premiums based on the policy holder’s health status,
not excluding coverage for pre-existing conditions and providing a minimum level of benefits. Health
insurance plans that do meet these new consumer protections cannot be sold. The intent of these
changes is to fix the current problems in the individual insurance market where sick people are charged
more or provided very limited health services. The goal of spreading the risk between the healthy and the
sick is to try to make it more like employer sponsored insurance where everyone pays the same premium
and the healthier people balance out the cost of people with more health needs. It is estimated that most
people purchasing health insurance coverage through the marketplaces will be eligible for premium tax
credits and other subsidies to make it more affordable. People who make less than 400% of the federal
poverty line are eligible for help ($45,960 for an individual or $94,200 for a family of four).


Civil Rights/Emergency Management – New York City in Violation of the Americans with
Disabilities Act for Failing to Accommodate Needs of Individuals with Disabilities

The Federal District Court in Manhattan found that New York City was in violation of the Americans with
Disabilities Act (ADA) for failing to accommodate the needs of individuals with disabilities before and
during emergencies. A lawsuit was filed following Tropical Storm Irene in 2011. The court found that the
city failed to develop evacuation plans for people with disabilities who lived in high-rise buildings based on
evidence that people were not able to get out of their apartments, had no water or heat, and had to wait
days for help. The city’s evacuation plans relied on the mistaken notion that everyone could evacuate
using stairs and inaccessible public transportation.

Civil Rights – The Department of Transportation Issues Regulations to Airlines Requiring
Them to Make Their Webpages Accessible

The Department of Transportation (DOT) issued regulations that require airlines to make their webpages
that contain “core travel information and services” accessible within two years. In three years, the websites
must be completely accessible. Within 10 years, at least 25 percent of kiosks at every airport must be
accessible. The rules will apply to all domestic airlines and all of those who fly to and from the US. In the
meantime, passengers who cannot access the current websites must be offered web-based discounts. DOT
also published final rules giving airlines more flexibility about how manual wheelchairs are stowed, allowing
that two manual folding wheelchairs can be transported at a time.

Civil Rights — The Department of Transportation (DOT) Fines US Airways

DOT fined US Airways $1.2 million for failing to accommodate passengers with disabilities using wheelchairs
in Philadelphia and Charlotte. Under DOT’s rules implementing the Air Carrier Access Act, airlines are required
to provide free, prompt wheelchair assistance upon request to passengers with disabilities.  This includes
helping passengers to move between gates and make connections to other flights. The fine is one of the
largest ever assessed by DOT in a disability case.

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Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)