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Plan to Join Us!! VOR 2007 Annual Meeting and Washington Initiative. See -
http://www.vor.net/VORAnnualMeeting2007.htm for complete details, including
a registration form.
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VOR is the only national organization advocating for a full range of
residential and support options for people with mental retardation,
including Medicaid-certified Intermediate Care Facilities for the Mentally
Retarded (ICFs/MR) and home and community-based care. VOR supports choice.
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VOR Weekly E-Mail Update
February 23, 2007
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1. Medicaid Enrollment in all 50 States
2. Bipartisan Group of Senators Wants To Work With Bush on Healthcare
Reform
3. Coalition Launches Ads Opposing Medicare, Medicaid Cuts
4. President's FY08 Budget Proposal - CCD Media Statement
5. Acting CMS Administrator Defends Funding In Bush Budget Lawmakers Voice
Concerns
Coming Up: Due to VOR travel, there will be no update Friday, March 2,
2007.
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1. Medicaid Enrollment in all 50 States
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"Medicaid Enrollment in 50 States" provides data on Medicaid enrollment by
state, including information updated through June 2005.
See -- http://ga3.org/ct/D1AHWJs1Ez9s/
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2. Bipartisan Group of Senators Wants To Work With Bush on Healthcare
Reform
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BNA
Volume 12 Number 31
Thursday, February 15, 2007
A bipartisan group of senators led by Sen. Ron Wyden (D-Ore.) has asked
President Bush to work with them to "fix the nation's healthcare system,"
and has proposed some principles for reform.
The White House reacted favorably to a Feb. 13 letter to Bush from the
group. A White House spokesman told BNA Feb. 14 that "we're very positive
on this, and see it as a sincere effort to try to find some common ground."
In their letter, the senators told Bush that they would "like to work with
you and your Administration to pass legislation in this Congress" embodying
six elements:
* ensuring that all Americans would have affordable, quality, private
health coverage, while protecting current government programs;
* modernizing federal tax rules for health coverage to avoid the tendency
in the current rules to "favor the most affluent, while promoting
inefficiency";
* creating more opportunities and incentives for states to design their own
health solutions;
* a switch in emphasis from the current focus on sick care to the creation
of "a culture of wellness through prevention strategies";
* encouraging more cost-effective chronic and compassionate end-of-life
care; and
* improving access to information on price and quality of health services.
In addition to Wyden, the group consists of Sens. Robert Bennett (R-Utah),
Maria Cantwell (D-Wash.), Kent Conrad (D-N.D.), Mike Crapo (R-Idaho), Jim
DeMint (R-S.C.), Herb Kohl (D-Wis.), Trent Lott (R-Miss.), Ken Salazar
(D-Colo.), and John Thune (R-S.D.).
White House Interested
White House spokesman Tony Fratto told BNA that, while the senators were
not endorsing Bush's own proposals for healthcare reform, "they certainly
are saying, 'You've put some interesting ideas on the table, some of which
we agree with, and we have some ideas. We'd like to come to the table and
talk about ways we can work together to try to find something that we both
can agree to.'... It's a good sign, especially in this environment. "
Of the six elements mentioned in the letter, Fratto said, the comments on
tax were particularly interesting. "The recognition of the unfairness of
the tax code, which the president laid out, is something that we feel very
strongly about," he said.
In their letter, the senators stressed the urgency of the issue. "Further
delay is unacceptable as costs continue to skyrocket, our population ages,
and chronic illness increases," the group said. "In addition, our
businesses are at a severe disadvantage when their competitors in the
global market get healthcare for 'free.'"
The senators said they did not share the view of some that the Senate was
too divided to pass comprehensive healthcare legislation. "We disagree with
those who believe that this issue should not come up until after the next
presidential election," they said. "We disagree with those who want to wait
when the
American people are saying, loud and clear, 'We want to fix healthcare
now.'"
Text of the letter is at
http://wyden.senate.gov/media/2007/02132007_Health_Care_Letter.htm
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3. Coalition Launches Ads Opposing Medicare, Medicaid Cuts
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Congressional Quarterly
February 8, 2007
A coalition of businesses, hospitals and hospital groups has launched a
million-dollar advertising campaign to urge Congress to reject cuts to
Medicare and Medicaid in the president's fiscal 2008 budget proposal.
The group, the Coalition to Protect America's Health Care, kicked off the
campaign Wednesday with print ads highlighting hospitals' role in caring
for America's most vulnerable patients. The campaign also will include
television and radio ads, to debut Feb. 12.
In a statement, the group said, "The nation's hospitals provide an
important safety net for much-needed health care upon which these citizens
depend, and the administration's fiscal year '08 budget proposal could put
at risk hospitals' ability to provide these important health care services
to all patients."
The president's proposal, released Monday, would slice a net $95.9 billion
from entitlement spending over the next five years, and $309 billion over
10 years. Medicare savings alone account for $66 billion over five years
and $252.4 billion over a decade. Much of the proposed savings would come
from cuts in payments to hospitals and other providers, but some would come
from charging higher monthly premiums to wealthier beneficiaries.
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4. President's FY08 Budget Proposal - CCD Media Statement
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Summary: The following is the Consortium for Citizens with Disabilities
statement in response to the President's Fiscal Year 2008 Budget Proposal,
submitted recently to Congress. Congress will consider the President's
proposal, but is in no way bound by the proposal. The Consortium for
Citizens with Disabilities is a NONPARTISAN coalition of over 100 national
consumer, provider, and advocacy organizations. The following statement is
highly critical of the President's budget proposal based on the issues, not
any particular partisan ideology. The article following this CCD statement
provides some information on the Administration's response to critics of
the President's budget proposal.
February 6, 2007
President's Budget Reveals Broken Promises and Wrong Priorities
Statement of the Consortium for Citizens with Disabilities on the
President's FY08 Budget Proposal
At the 16th Anniversary of the Signing of the Americans with Disabilities
Act last July, President Bush stated his commitment to ensuring that the
fundamental promises of our democracy are accessible to all our citizens.
The Administration's fiscal year 2008 budget breaks this promise of full
citizenship. President Bush's budget and tax policy, emphasizing wealth
over opportunity, simply fails to match his rhetoric.
It is obvious from the abysmal FY 2008 budget request that this
Administration indeed does plan to finance an unpopular war and tax cuts as
well as achieve a balanced federal budget on the backs of people with
disabilities, said Marty Ford, Chair of the Consortium for Citizens with
Disabilities.
The services and supports targeted by the Bush Administration enable
millions of Americans with disabilities to learn, work, pay taxes, live in
their communities, and make significant contributions to our society.
Among the key disability related federal programs targeted for elimination,
cutbacks, or freezes in funding include:
Broken Promise: Medicaid and Medicare
During the Presidents State of the Union Address, he stated that "When it
comes to health care, government has an obligation to care for the elderly,
the disabled and poor children." However, the Presidents budget includes
legislative proposals that would cut key entitlement programs by $101.5
billion over the next five years $75.8 billion in Medicare and $25.7
billion in Medicaid. Some of these cuts, $10.2 billion in Medicare and
$12.7 billion in Medicaid, would be achieved through administrative actions
by the Centers for Medicare and Medicaid Services (CMS) while the remaining
cuts would need to be enacted by Congress.
Broken Promise: Childrens Health
Although nearly six million low-income children remain uninsured today, the
budget fails to provide sufficient funds for the State Childrens Health
Insurance Program simply to maintain current levels of coverage and
represents a step backward from the goal of covering all low-income
children. In addition, small health prevention programs that provide a big
impact such as the traumatic brain injury and childrens newborn hearing
screening program are zeroed out.
Broken Promise: Human Services
During the signing of the Combating Autism Act, President Bush stated that
"for the millions of Americans whose lives are affected by autism, today is
a day of hope. The Combating Autism Act of 2006 will increase public
awareness about this disorder and provide enhanced federal support for
autism research and treatment. By creating a national education program for
doctors and the public about autism, this legislation will help more people
recognize the symptoms of autism. This will lead to early identification
and intervention, which is critical for children with autism. However, the
Presidents budget provides no funding
for this new law.
Broken Promise: Employment
After promising to expand employment opportunities for people with
disabilities as part of his New Freedom Initiative, the President proposed
for the seventh year in a row to eliminate the supported employment program
that successfully assists people with significant disabilities to work in
the community and be productive tax-paying citizens. For the first time
since the Congress added a mandatory increase to the Vocational
Rehabilitation State Grant program based on the Consumer Price Index more
than two decades ago, this Administration even failed to add the CPI
increase to its budget request. Total VR Act funding is cut by $54 million
while millions of Americans with disabilities remain unemployed. In
addition, the President again proposes to cut the Assistive Technology
program that assists individuals with disabilities to be successful and
included in classrooms and at work by over $4 million.
Broken Promise: Education
The President seeks to level fund the Individuals with Disabilities
Education Act (IDEA) State Grant, the Preschool Grant and the Part C Early
Intervention programs and cut the IDEA National Activities programs by $64
million. The IDEA State Grant request would actually decrease the per
pupil federal share of funding for students with disabilities below 17%,
well below the authorized amount of 40%. That share has dropped about 3%
in the last several years. The special education teacher preparation
program is frozen at a critical time when school systems grow desperate to
hire highly qualified teachers to implement the requirements of No Child
Left Behind. A large proportion of special education students are taught
every day by unqualified teachers, let alone those who are highly
qualified.
Broken Promise: Housing
For the third consecutive year, the Presidents budget proposes to slash the
Section 811 Supportive Housing Program for Persons with Disabilities, a 46%
cut. Most of the $113 million cut would come from the programs capital
advance component - the only federal program that produces affordable and
accessible housing for low-income persons with significant disabilities.
Broken Promise: Research
For the National Institutes of Health, the Administration proposes $28.6
billion for FY 2008, which is $310 million less than the funding level in
the final FY 2007 Joint Funding resolution passed by the House last week.
In addition, the Administration proposes to increase the Global AIDS
Transfer out of NIH by $201 million, effectively cutting the agencys budget
by $511 million in FY 2008 and reducing it to its FY 2005 funding level.
The President's fiscal year 2006 budget reveals broken promises and wrong
priorities. The Consortium for Citizens with Disabilities urges the U.S.
Congress to reject the Administration's budget cuts and to reaffirm the
promise of full citizenship for America's citizens with disabilities.
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5. Acting CMS Administrator Defends Funding In Bush Budget Lawmakers Voice
Concerns
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BNA
Volume 12 Number 30
Wednesday, February 14, 2007
Acting Centers for Medicare & Medicaid Services Administrator Leslie V.
Norwalk Feb. 13 defended the president's fiscal year 2008 budget proposal
to trim Medicare and Medicaid funding by about $101 billion over five
years, including plans to reduce Medicare provider spending.
In testimony to the House Ways and Means Health Subcommittee, Norwalk
highlighted what she characterized as positive trends in the Medicare
Advantage and Part D prescription drug programs.
However, subcommittee Chairman Pete Stark (D-Calif.) said he was
"disappointed with the President's budget." He added, "We're going to have
to set aside this budget" and come up with something "from scratch."
In her testimony, Norwalk said, "Experience with Medicare Part D to date
demonstrates the great potential of market reforms to save Medicare
dollars, while also promoting beneficiary choice and satisfaction."
In addition, beneficiaries enrolled in Medicare managed care plans
(Medicare Advantage) "have access to integrated health and prescription
drug benefits, often with lower premiums and cost-sharing than under
fee-for-service Medicare," she said.
Committee Members Voice Skepticism
Along with Stark, many Democrats on the subcommittee expressed skepticism
at Norwalk's claims, questioning the value of higher payments that Medicare
managed care plans often receive.
Republican members of the subcommittee also voiced their concerns with the
president's fiscal 2008 budget proposal, asking why the administration
chose not to address problems in Medicare's physician payment formula.
The proposal leaves overpayments in place for private plans, while cutting
other parts of the program, Stark said. The budget would require
beneficiaries to pay higher Part B premiums and would raise rates for many
higher-income beneficiaries, he said.
The proposal also provides more than $3 billion for health savings
accounts, which primarily benefit upper-income families, while
shortchanging the State Children's Health Insurance Program by $12 billion,
he said.
In the past, Stark said, both the president and Congress worked to ensure
that Medicare remained a guaranteed retirement benefit for all of America's
seniors. This latest budget proposal "is designed to convert Medicare from
a program to cover all seniors to one which covers only those who have no
other option."
Managed Care
Stark also highlighted the president's failure to reduce spending for
Medicare Advantage programs, calling Medicare managed care plans "the one
group that stands out as not having contributed anything" to the budget
cuts.
"Medicare Advantage plans have been left out of the loop, and I don't want
them to feel overlooked," he quipped.
Norwalk said managed care plans would be impacted under the president's
budget because Medicare Advantage program benchmarks would be affected by
any changes to Medicare Part A and B programs.
Medicare managed care plans also provide additional benefits to
beneficiaries, she added. For example, more than 85 percent of Medicare
Advantage beneficiaries have access to zero premium plans, she said. On
average, beneficiaries in Medicare managed care plans save $86 per month,
she added.
Minorities and low-income beneficiaries receive the greatest benefit from
Medicare Advantage plans, Norwalk said. As a percentage, more minorities
and low-income populations are enrolled in Medicare Advantage plans than in
traditional fee-for-service plans, she said.
Physician Payments
The president's budget did not discuss the sustainable growth rate formula.
For physicians, the SGR formula has led to cuts in Medicare reimbursements
that will continue in 2008 and beyond.
The lack of discussion prompted questions from Democrats and Republicans
alike.
Rep. Earl Pomeroy (D-N.D.) said the president provided a "goose egg" in
terms of providing a multi-year fix to the SGR formula.
Subcommittee ranking member Dave Camp (R-Mich.) said the administration
could have taken a number of steps to help improve the physician payment
system, such as removing drug payments from the SGR formula.
Norwalk said the budget does recognize that the SGR formula "is a problem."
She said CMS would like to become a "more active purchaser" of health care
services to better reward efficient behavior among physicians, something
the current SGR formula does not do.
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Tamie Hopp
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