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FINAL REMINDER:
Tamie Hopp’s new email address is Tamie327@hotmail.com. vor@compuserve.com
is no longer valid. See http://www.vor.net/staff for additional
VOR addresses and contact information.
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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
November 2, 2007
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Table of Contents
1. H.R. 3995 – HAVE YOU CALLED YOUR US
REPRESENTATIVE YET (those opposing the bill have) – CALL TODAY
2. A Check for Social Security – House and Senate Appropriators
agree to propose an increase in funding for the Social Security
Administration
3. Medicaid Costs Increase by 10.7% in First Half of 2007,
According to Report
4. 50 STATE SURVEY REPORTS MEDICAID ENROLLMENT DECLINES FOR THE
FIRST TIME IN NEARLY A DECADE; BUT 42 STATES ARE PLANNING TO
EXPAND COVERAGE FOR UNINSURED
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1. H.R. 3995 – HAVE YOU CALLED YOUR
US REPRESENTATIVE YET (those opposing the bill have) – CALL
TODAY
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Our opposition is working hard, so we must also. All it takes is
a phone call or a fax and a little follow-through. If not you,
who?
Please call today and ask your U.S. Representative to COSPONSOR
H.R. 3995.
VOR’s detailed action alert, including links to Congressional
contact information and a template letter can be found at the
VOR website:
http://vor.net/HR3995AlertOct.htm
CALL TODAY!!! THANK YOU FOR YOUR EFFORTS!!
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2. A Check for Social Security – House and Senate Appropriators
agree to propose an increase in funding for the Social Security
Administration
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Summary: The House and Senate appropriations committees agreed
to provide the agency with $9.9 billion for operations in fiscal
2008. That is $275 million more than the Bush administration
requested and probably enough to keep Social Security from
drowning, at least for the short term, in its growing workload.
Forty organizations, including VOR, AARP, Easter Seals, Gray
Panthers and various labor unions, wrote House appropriators
this month to urge increased funding for Social Security. Their
letter said that Social Security field offices get about 850,000
visitors per week and that visitors at many field offices have
to wait more than two hours for service.
A Check for Social Security
By Stephen Barr
Friday, November 2, 2007; D04
Washington Post
The Social Security Administration -- where staffing is at its
lowest levels since the 1970s and the number of disability
claims are at an all-time high -- got some hopeful news on its
budget yesterday.
The House and Senate appropriations committees agreed to provide
the agency with $9.9 billion for operations in fiscal 2008. That
is $275 million more than the Bush administration requested and
probably enough to keep Social Security from drowning, at least
for the short term, in its growing workload.
"It is good news," said Richard E. Warsinskey, president of the
National Council of Social Security Management Associations. "It
won't solve the backlog we have, but it will help address the
backlog."
The funding increase is part of a huge spending bill that
includes $150.7 billion for education, job training, medical
research and social services. The bill is $9.8 billion above
what President Bush requested, and his aides have predicted he
will veto it.
So the agency's managers and groups that represent retirees are
lobbying to hang on to the money. "If we end up going backward,
we could get in trouble again," Warsinskey said.
About 746,000 cases are lined up for hearings on disability
claims, and the average wait is 512 days. Sen. Jeff Bingaman (D-N.M.),
the chief sponsor of an amendment to increase Social Security's
budget for next year, said the number of disabled workers
drawing disability benefits has more than doubled since 1990, to
6.8 million from 3 million.
The Social Security workload will grow over the next decade as
baby boomers retire. The number of workers receiving Social
Security benefits is projected to increase during that period by
13 million.
But staffing at Social Security will soon be at its lowest level
since 1973. The number of workers will drop below 60,000 in the
second half of fiscal 2008, the agency estimates. Thirty years
ago, it had about 87,000 employees.
Forty organizations, including AARP, Easter Seals, Gray Panthers
and various labor unions, wrote House appropriators this month
to urge increased funding for Social Security. Their letter said
that Social Security field offices get about 850,000 visitors
per week and that visitors at many field offices have to wait
more than two hours for service.
Those waits could get longer. About 41 percent of claims
representatives, a key sector of Social Security's workforce,
will be eligible to retire by 2010, according to the nonprofit
Partnership for Public Service.
Michael J. Astrue, the Social Security commissioner, has said
that inadequate funding since 2001 is largely to blame for
staffing and workload problems.
In a September letter to Sen. Tom Harkin (D-Iowa), whose
subcommittee on appropriations oversees the agency's funding,
Astrue said Social Security requires a minimum increase of about
$300 million each year to pay for rent, guards, postage, raises
and benefits.
"Under any funding scenario in fiscal 2008, SSA has limited
remaining resources to use to drive down the hearings backlog,"
he wrote.
In the next year, field offices "will be unable to replace
employees who leave," he said.
The only significant hiring will be for hearings, where the
agency hopes to add about 150 administrative law judges,
starting in the spring, Astrue said.
Mark Lassiter, the Social Security press officer, said "it is
too early to tell" what the agreement by the congressional
negotiators will mean for the agency. He noted that any
workload-related decisions will have to wait until after an
official budget is transmitted to the agency.
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3. Medicaid Costs Increase by 10.7% in First Half of 2007,
According to Report
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USA Today
Early October, 2007
Medicaid spending has started to soar again, a sharp reversal
from last year when costs unexpectedly fell for the first time
since the program began in 1965.
The state-federal health care program for the poor experienced a
10.7% jump in costs during the first six months of the year,
according to a USA TODAY analysis of Bureau of Economic Analysis
data. That's the biggest increase since 2001 and puts Medicaid
on pace to spend a record $330 billion in 2007.
"States are going to have to make some tough decisions on who
receives care, what care they get and what the limitations are,"
says Robert Campbell, vice chairman of Deloitte & Touche USA, an
accounting and consulting firm that works with state and local
governments.
He expects costs to continue to rise for the foreseeable future
as states try to reduce the number of the uninsured amid rising
medical costs.
Higher Medicaid spending could squeeze state finances at a time
when revenue growth in many states is being slowed by the
slumping housing market. State tax collections have grown about
5% this year, down from 9% growth in 2005, according to Bureau
of Economic Analysis data. Medicaid recently surpassed education
as the biggest item in state budgets.
The Medicaid spending burst may signal the end of a two-year
period when costs seemed to be coming under control. Costs grew
5.1% in 2005 and declined 1.7% in 2006.
Spending fell last year because a variety of cost controls —
such as moving patients from nursing homes to lower-cost home
health care — produced unexpectedly large savings. Also,
Medicaid shifted some costs into the new Medicare
prescription-drug benefit program. Medicare, the federal program
for the elderly, will cost about $440 billion this year.
Medicaid and the related Children's Health Insurance Program are
state-run health insurance plans for the poor. States pay 43% of
the cost. The federal government pays the rest and sets broad
rules. Medicaid pays nursing home costs for seniors who have
exhausted their savings.
It's not clear why Medicaid costs have started to rise again.
Possible causes:
*Efforts to cover the uninsured. States have won federal
approval to expand coverage to groups that don't normally
qualify for Medicaid, Campbell says. These high-profile efforts
to reduce the uninsured population rely heavily on the federal
government paying costs through the Medicaid and children's
health programs. The Bush administration had encouraged these
efforts until recently but now is expressing concerns about
costs. President Bush last week vetoed expanding the child
health program, saying it has gone too far beyond its mission of
insuring low-income children.
*Enrollment growth. Medicaid temporarily bumped tens of
thousands of qualified people from the program last year because
Congress imposed tougher proof-of-citizenship requirements. Now,
the application backlog is being cleared and retroactive
payments made for medical costs incurred in 2006.
*Paying doctors and hospitals more. Boosted by strong tax
collections, many states have increased what they pay for
Medicaid services. In most states, Medicaid pays less than
private insurance or Medicare.
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4. 50 STATE SURVEY REPORTS MEDICAID ENROLLMENT DECLINES FOR THE
FIRST TIME IN NEARLY A DECADE; BUT 42 STATES ARE PLANNING TO
EXPAND COVERAGE FOR UNINSURED
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Summary: Low Spending Growth and Improved Economy Allow States
to Focus on Program Improvements, As Well As Cost Control.
However, see related article (above): “Medicaid Costs Increase
by 10.7% in First Half of 2007, According to Report”
WASHINGTON, DC - Enrollment in Medicaid declined for the first
time in nearly a decade, according to a new 50-state survey
released today by the Kaiser Family Foundation’s Commission on
Medicaid and the Uninsured (KCMU).
But faced with an improving economy, 42 states expect to expand
coverage to the uninsured in the next year.
The survey reports a 0.5 percent enrollment decline in fiscal
year (FY) 2007 driven primarily by two factors. States reported
that the new documentation requirements were causing significant
delays in processing applications, affecting mostly individuals
already eligible for the program.
State officials also cited the good economy and lower
unemployment for reducing enrollment. After an all-time low for
Medicaid spending growth in FY 2006, Medicaid spending continued
to grow slowly by 2.9 percent in 2007 due largely to the decline
in enrollment and the continued transition of prescription drug
costs for dual eligibles from Medicaid to Medicare. States
expect enrollment and spending to increase in FY 2008 as they
move forward with program enhancements.
The budget survey of state officials, conducted by KCMU and
Health Management Associates for the seventh consecutive year,
found that this year more states than in previous times were
pursuing policies to remove restrictions put in place during
poor economic conditions and improve their programs. With the
nation’s growing uninsured population, 42 states report efforts
underway to expand coverage to their uninsured population using
Medicaid as a financing vehicle for coverage efforts. Many of
these efforts, however, will depend on the outcome of the
federal debate on the reauthorization of the State Children’s
Health Insurance Program (SCHIP) in light of the president’s
veto.
Medicaid Policy Initiatives for FY 2007 and FY 2008
Unlike their singular focus on cost containment in earlier
years, states have moved now to a range of priorities including
expanding eligibility and benefits, improving quality, and
changing the delivery of long-term care services. All states and
the District of Columbia implemented at least one provider
payment increase in FY 2007 and almost all (49 states) adopted
an increase for FY 2008.
More than half of all states for FY 2007 and FY 2008 expanded
eligibility, including increases in income limits, new group
expansions, or streamlining the application or renewal process.
For the first time since FY 2003, no state plans to cut a
benefit in FY 2008.
In FY 2007, 35 states expanded long-term care services and 46
states plan to do so in FY 2008. In both years, the most
commonly reported expansions were expanding existing home and
community based service waivers or adopting new waivers.
To improve care and achieve better value in their Medicaid
programs, by FY 2008, 44 states will require health care plans
to report performance measures through HEDIS or CAHPS. Twenty
seven states will have pay-for-performance programs providing
incentives for programs like tobacco cessation and payments tied
to hospital readmission rates for chronic conditions such as
asthma and diabetes.
The Impact of the Deficit Reduction Act of 2005
The Deficit Reduction Act (DRA) of 2005 included several changes
to federal Medicaid policy, including a new requirement that
states obtain documentation to prove citizenship and identity
for individuals applying for or renewing Medicaid coverage.
Three out of four states reported that the new rules contributed
to slower enrollment growth in FY 2007 and caused significant
delays in processing applications and increased the
administrative burdens placed on states.
To date, seven states have plans approved using new DRA options
on benefits and cost sharing.
Kentucky, West Virginia and Idaho moved forward with
comprehensive redesigns of their Medicaid benefits and four
other states (Kansas, Virginia, Washington, and South Carolina)
received approval for more targeted flexibility.
For FY 2008, Wisconsin intends to seek approval to offer a
modified benefits package for an expansion population.
The DRA also provided more state options for flexibility in
long-term care.
Nearly half (24) of states reported plans to implement a
Long-Term Care Partnership Program in FY 2008 to help increase
the role of private long-term care insurance.
Take up of new state plan options for cash and counseling and
the home and community based services option has been more
limited.
Medicaid and Health Care Reform
Declines in employer-sponsored coverage continue to swell the
ranks of the uninsured, with 47 million uninsured in 2006.
States have been at the forefront in seeking ways to decrease
the number of uninsured.
Forty-two states said they have plans to expand coverage to this
population and three indicated that they were having discussions
but had not yet made a decision to move forward yet.
Thirty-eight of the 42 states reported that Medicaid would have
a role in financing their plans while 34 states responded that
Medicaid would play a role in enrollment.
Today’s released report, “As Tough Times Wane, States Act to
Improve Medicaid Coverage and Quality: Results from a 50-State
Medicaid Budget Survey for State Fiscal Years 2007 and 2008,”
and related materials are available at http://www.kff.org/medicaid/kcmu101007pkg.cfm.
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Tamie Hopp
REFERRAL/MEMBERSHIP/CONTRIBUTION FORM
THREE EASY WAYS TO SUPPORT VOR > REFER, CONTRIBUTE OR JOIN
THANK YOU FOR YOUR SUPPORT!
TO JOIN OR CONTRIBUTE: $25 per individual, $150 per family
organization, or
$200 per provider/professional organization. Extra donations are
welcome!
You may pay by credit card or check.
TO REFER SOMEONE TO VOR: Use the form below, including the
additional
sections for referrals.
Mail the completed form (if joining or contributing) with
payment to:
Voice of the Retarded
836 S. Arlington Heights Rd., #351
Elk Grove Village, IL 60007
847-258-5273 fax (for referrals or credit card payments)
kluck146@comcast.net (for referrals or credit card payments)
FOR REFERRALS: ____ The contact information provided is for
someone I
think would consider membership with VOR.
FOR REFERRALS: _____ You may use my name in any correspondence
with this
individual. My name is ________________________.
____________________________________________
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forms must
include complete address including zip code)
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please
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