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H.R. 3995 - ACTION ALERT - CALLS TO CONGRESS NEEDED TODAY!!! ORGANIZATION SIGN ON OPPORTUNITY - SUPPORT H.R. 3995.
Join Us! VOR will host its Annual Meeting and Washington Initiative beginning June 13, 2008 in Washington, D.C. Visit http://vor.net/2008AnnualMeetingandInitiative.htm for more information on the Annual Meeting and Initiative, and sponsorship opportunties, or contact Tamie at Tamie327@hotmail.com or 605-399-1624.
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Have you contacted your U.S. Representative and asked him/her to cosponsor H.R. 3995? If yes, have you followed-up? Contact Tamie with any questions and to receive H.R. 3995 advocacy materials (605-399-1624; tamie327@hotmail.com)
--------------------------------------- VOR Weekly E-Mail Update February 1, 2008 ---------------------------------------- ======================================================================= Table of Contents
1. Economic Stimulus Package – Update 2. Democratic Lawmakers Say CMS Has No Authority To Limit State Efforts To Expand Medicaid Eligibility3. Bush Seeks Surplus via Medicare and Medicaid Cuts
4. SSA to Partially Suspend Regulation Restricting Appeal Rights for Disabled Individuals / Strong opposition from Congress and public forces reconsideration
5. TEXAS NEWS: Craddick picks panel to watch Texas state institutions for disabled; Members asked to find ways to improve care, shorten waits for aid =======================================================================
---------------------------------------------------------- 1. Economic Stimulus Package – Update ----------------------------------------------------------
Summary: This relates to advocacy efforts to secure, as part of the broader economic stimulus package, a temporary increase in the federal Medicaid match received by states. Senator Rockefeller had planned to introduce an amendment during the Senate Finance Committee deliberations (“mark up”) earlier this week. VOR joined many other national organizations in calling on Congress to support a temporary federal Medicaid match increase.
Source: AFSCME, January 30, 2008
The Senate Finance Committee met this afternoon and passed its economic stimulus package. Unfortunately, because Senator Rockefeller’s amendment was determined to be non-germane to the bill (which did not contain any healthcare provisions) it was not offered. At the markup, Senator Rockefeller noted that when unemployment goes up by 1 percent, an additional 2 to 3 million people go on Medicaid. Senator Bingaman also discussed how the current CMS regulations shift Medicaid expenses to states and called for redress of this situation.
While this development in the Finance Committee is disappointing, a second stimulus bill was mentioned several times by both sides of the aisle. We must continue the drumbeat that state-local fiscal relief and an increase in FMAP are needed urgently. Allies and Democratic Governors will talk about the pressing need for fiscal relief and a boost in FMAP at the House Democratic Retreat this weekend. Next week’s release of the President’s budget should offer us another opportunity to continue the drumbeat.
We continue to explore with allies on the hill how to move this issue forward beyond the initial stimulus package.
---------------------------------------------------------- 2. Democratic Lawmakers Say CMS Has No Authority To Limit State Efforts To Expand Medicaid Eligibility----------------------------------------------------------
VOR Note: VOR joined with several other national organizations to call on House leaders to take action to reverse CMS’ August 17, 2007 actions because, “The CMS letter was unprompted by legislation and did not follow standard SCHIP and Medicaid rule-making procedures, effectively changing federal policy without any formal review process or public comment period . . .” We are concerned unilateral actions by federal agencies that effectively change Medicaid law. Several states have filed suit against CMS challenging the legality of the directive.
Democratic Lawmakers Say CMS Has No Authority To Limit State Efforts To Expand Medicaid Eligibility Medical News Today
January 17,
2008 -------------------------------------------------------------------------------------------------------------------- 3. Bush Seeks Surplus via Medicare and Medicaid Cuts --------------------------------------------------------------------------------------------------------------------
Summary: The New York Times article below previews what we might expect from the President's budget on Monday: cut to Medicaid and Medicare.
Bush Seeks Surplus via Medicare and Medicaid Cuts January 31, 2008 By Robert Pear The New York Times
WASHINGTON — In his new budget, to be unveiled Monday, President Bush will call for large cuts in the growth of Medicare, far exceeding what he proposed last year, and he will again seek major savings in Medicaid, according to administration officials and budget documents.
Over all, the 2009 budget is likely to be the first $3 trillion spending request by a president. Health care savings are a crucial part of Mr. Bush’s plan to put the nation on track to achieve a budget surplus by 2012. But before then, the officials said Wednesday, the White House anticipates higher deficits in 2008 and 2009, reflecting the current weakness of the economy and the cost of a stimulus package.
The president’s budget will not seek money for another full year of the wars in Iraq and Afghanistan. Pentagon officials said the administration would request $70 billion for the fiscal year that begins on Oct. 1. That would be enough to continue combat operations for several months, until the next president takes office.
Mr. Bush has repeatedly said that the costs of Medicare and Medicaid, which dwarf spending for lawmakers’ pet projects, are unsustainable. The two health programs account for nearly one-fourth of all federal spending, and their combined cost — $627 billion last year — is expected to double in a decade.
Budget documents show that Mr. Bush will propose legislative changes in Medicare to save $6 billion in the next year and $91 billion from 2009 to 2013. In his last budget, by contrast, his legislative proposals would have saved $4 billion in the first year and $65.6 billion over five years.
The president’s budget also takes aim at Medicaid, the insurance program for low-income people. He would pare $1.2 billion from it next year and nearly $14 billion over five years. Those figures do not include tens of billions of dollars that Mr. Bush wants to save through new regulations. Such rules are not subject to approval by Congress, but could be revised by a future administration.
Congressional Democrats often pronounce Mr. Bush’s budget dead on arrival, and they have no reason to make unpopular cuts in this election year.
But lawmakers say they feel obliged to pass a Medicare bill in the first half of this year, to spare doctors from a 10 percent cut in Medicare fees that would otherwise take effect on July 1. Lawmakers say that bill could easily become a vehicle for other changes in Medicare and Medicaid.
Most of the Medicare savings in the budget would be achieved by reducing the annual update in federal payments to hospitals, nursing homes, hospices, ambulances and home care agencies. The budget would not touch payments to insurance companies for private Medicare Advantage plans, even though many Democrats and independent experts say those plans are overpaid.
In the next five years, the largest amount of Medicare savings, by far, would come from hospitals: $15 billion from an across-the-board reduction in the annual updates for inpatient care; $25 billion from special payments to hospitals serving large numbers of poor people; and $20 billion from capital payments for the construction of hospital buildings and the purchase of equipment.
In addition, the president’s budget would reduce special Medicare payments to teaching hospitals, including many in the New York area, by $23 billion over the next five years.
To justify prior budget proposals, the White House has often cited the work of an independent federal panel, the Medicare Payment Advisory Commission. The panel voted this month to recommend that Medicare payments to hospitals be increased about 3 percent in 2009, to reflect the expected increase in the cost of goods and services hospitals use. Under the president’s budget, Medicare payments would not keep pace with those costs in 2009 or any subsequent year.
The advisory panel found that the special Medicare payments to teaching hospitals were excessive, as the White House contends. But it recommended a much more modest cutback than Mr. Bush will propose.
Kenneth E. Raske, president of the Greater New York Hospital Association, said the president’s proposals showed “great insensitivity to teaching hospitals” across the country. The proposals “would undermine our ability to train young doctors at a time when the nation is facing a shortage of doctors,” Mr. Raske said.
Under the president’s budget, Medicare payment rates for nursing homes would be frozen in 2009, and payment rates for home health agencies would be frozen at current levels through 2013.
William A. Dombi, vice president of the National Association for Home Care and Hospice, a trade group, said the proposal could affect many of the three million Medicare beneficiaries who receive home health services each year.
“Under the proposal,” Mr. Dombi said, “75 percent to 80 percent of home health agencies would be doomed. They would not be able to meet payroll. They would not be able to operate.”
Within 15 days of sending his budget to Congress, Mr. Bush is supposed to submit legislation to strengthen the financial condition of Medicare and to reduce its reliance on general revenues, which include income taxes. The 2003 Medicare law established special procedures to ensure that Congress would consider such legislation.
House Democrats want to eliminate this requirement, saying it is a Republican device to undermine Medicare’s status as an entitlement.
4. SSA to Partially Suspend Regulation Restricting Appeal Rights for Disabled Individuals / Strong opposition from Congress and public forces reconsideration</ --------------------------------------------------------------------------------------------------------------------
House Committee on Ways and Means – Press Release Wednesday, January 30, 2008
WASHINGTON, D.C. -- The Social Security Administration (SSA) today notified Congress that the agency would suspend some parts of a controversial proposed regulation that would sharply restrict appeal rights for severely disabled individuals applying for benefits.
Under the proposed regulation, severely disabled persons would have been denied access to over $2.0 billion in Social Security and Supplemental Security Income (SSI) benefits over the next ten years – not because their disabilities were not severe enough, but because they could not successfully navigate the complex new procedural requirements established by the proposed rule. Those denied would also have lost access to critical Medicare and Medicaid benefits.
"This proposal would have complicated the disability system and denied benefits to deserving folks – I commend the SSA for reconsidering it," said Ways and Means Committee Chairman Charles B. Rangel (D-NY). "We should be looking for ways to improve, not complicate, the current disability system. Our immediate priority is making sure SSA has enough disability claims examiners and judges to dramatically reduce the backlog of unprocessed claims. In the future, I look forward to working with the agency to ensure that the right balance is struck between speedy processing and adjudicating claims in a way that is thorough, fair, and accessible to claimants."
The proposed regulation engendered a strong outcry from Congress and advocacy organizations. A letter objecting to the regulation was sent in December by eleven House Committee and Subcommittee chairs. Letters objecting to the proposal were also sent by the Senate Finance Committee and other Senate leaders, and almost 500 comments were filed on the regulation, primarily in opposition.
"I am pleased that Social Security Commissioner Astrue has pledged to work with Congress to improve the disability process," said Ways and Means Social Security Subcommittee Chairman Michael R. McNulty (D-NY). "It is essential that SSA bring down the backlog in a way that does not harm those we are trying to help. In my view, the most important thing we can do is to work together to ensure that SSA has sufficient resources to process the claims it receives without imposing intolerable waits and hardships on those suffering from severe disabilities."
The agency has agreed to suspend some portions of the regulation and will seek additional public input. However, it remains to be seen whether all aspects of the regulation that would unfairly harm disability applicants will be revised. The Committee on Ways and Means will continue to provide close oversight of the process and any proposed changes.
-------------------------------------------------------------------------------------------------------------------- 5. TEXAS: Craddick picks panel to watch Texas state institutions for disabled; Members asked to find ways to improve care, shorten waits for aid --------------------------------------------------------------------------------------------------------------------
Wednesday, January 16, 2008 The Dallas Morning News
By Emily
Ramshaw AUSTIN – House Speaker Tom Craddick created a special committee Wednesday to monitor state institutions for people with disabilities, saying conditions reported at those facilities warranted greater oversight.
The panel is charged with finding ways to improve the quality of care for people with the most severe disabilities – those who require round-the-clock assistance and are placed in institutions.
Members will also review the lengthy interest lists for people who want care at home or in community group homes, for which some wait up to a decade. More than 100,000 Texans are waiting for such services.
"The Legislature recognized there were immediate needs in institutional care for Texans with disabilities," Mr. Craddick, R-Midland, said in a written statement announcing the creation of the nine-member panel. "Though funding and supervisory changes have occurred, further attention is warranted."
Some House Democrats say the attention is too little, too late. Under the leadership of Rep. Garnet Coleman, D-Houston, they kicked off their own study of state schools for the mentally retarded late last year.
Mr. Craddick's select committee "should've happened sooner – it's sort of a late wake-up in my opinion," Mr. Coleman said. "The state has done poorly by its most vulnerable people."
The move comes five months after The Dallas Morning News first uncovered widespread abuse and neglect in the state schools for the mentally retarded, as well as other private-care facilities for people with disabilities.
And it follows a December report in The News that Mr. Craddick had yet to order a study on the problems, despite releasing other charges for committees to consider before the next legislative session in 2009. Mr. Craddick said last summer that addressing mistreatment in the facilities was a priority.
The committee, which has investigative power, must report back to the Legislature with recommendations by December. Members will hold several hearings across the state and will probably author clean-up legislation.
"This is not a partisan issue or a political issue, and it shouldn't be," said Rep. Larry Phillips, the Sherman Republican appointed to chair the committee. "These Texans deserve all of our attention. We need to see what's going on in other states. We need to see what steps we can take to have the most impact."
Advocates for the disabled say appointing the House committee is a step in the right direction – though they're hopeful they'll see action in the Senate, too.
"If they do a really objective look at the issues facing people in state institutions, it can only be good for everyone," said Jeff Garrison Tate, spokesman for Advocacy Inc. Rich Parsons, spokesman for Lt. Gov. David Dewhurst, said Mr. Dewhurst's charges for committee work before the next session will be released soon. He didn't indicate whether state schools would make the cut.
---------------------------------------------------------- Tamie Hopp
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