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Opposition to S. 799 and H.R. 1621: The Community Choice Act of 2007
(a/k/a The Medicaid Community-Based Attendant Services and Supports Act – MiCASSA)
VOR opposes S. 799, the Community Choice Act of 2007, introduced by Senator Tom Harkin (D-IA), and H.R. 1621, introduced by Rep. Danny Davis (D-IL). If passed, the effect of this legislation will be the elimination of necessary services for citizens with severe and profound mental retardation.
This legislation has been introduced in every session since the 105th Congress (1997) and, like its predecessors, the Community Choice Act of 2007 proposes a new mandatory Medicaid entitlement for community-based personal attendant care services for individuals eligible for care in Intermediate Care Facilities for Persons with Mental Retardation (ICFs/MR) or nursing facilities.
At the time of the original introduction of this legislation in 1997, the Congressional Budget Office (CBO) estimated that 8 million people might be eligible. Assuming that only 2 million would actually request the benefit, CBO estimated an annual federal cost of $10-20 billion:
“This bill would increase overall costs, however, because limited reductions in nursing home care would be more than offset by demand for the new services, including services for people who would not otherwise have entered an institution . . . CBO estimates that the bill could cost the federal government $10 billion to $20 billion a year.” (June O’Neill, Director, Congressional Budget Office, October 14, 1997). [emphasis added]
The mandatory Medicaid entitlement proposal within S. 799 and H.R. 1621 is the primary reason for the high cost projections. For States to accommodate this increase in mandatory Medicaid expenditures, funding for optional Medicaid programs, such as the optional 1915(c) Home and Community-Based Services (HCBS) waiver, the optional state plan personal care services benefit, and the optional ICFs/MR program, will have to be cut. Quality and availability for the people who rely on these programs will suffer.
Conclusion
This expansion of needed community services should be accomplished without putting services for Medicaid-eligible people with severe and profound mental retardation, who have even greater care needs, at risk. Those who stand to be hurt by these good intentions are the neediest, most fragile, and most disabled of our nation’s citizens: People with severe and profound mental retardation who require the stability and quality of ICFs/MR and HCBS supports.
For more information, please contact: Tamie Hopp, VOR Director of Government Relations and Advocacy 605-399-1624 * 605-399-1631 fax * tamie327@hotmail.com
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VOR * 836 S. Arlington Heights Rd., #351 * Elk Grove Village, Illinois * 60007 877-399-4VOR ph. * 847-253-0675 fax * tamie327@hotmail.com |
