February 17, 2012

February 17 Washington Update


Greetings from Washington.  It was great to see some of you at the AMCHP conference and to know that some of you were able to educate your Members of Congress about your work while you were here in DC.  If you have not already given us feedback on your Hill visits, consider this a gentle reminder.

F2F fundingThere have been several developments - both good and bad (but not too bad) -- in our efforts to get funding extended for F2Fs.  First the good...   

Menendez-Pallone bills.  The bills were introduced today!  Thanks to your efforts, we have multiple original cosponsors for both the Senate and House bills.  In the Senate they are:  Senators Kent Conrad (D-ND), Jeff Bingaman (D-NM), Sheldon Whitehouse (D-RI), Frank Lautenberg (D-NJ), and {drum roll please...} Olympia Snowe (R-ME), so the bill is now bipartisan! 

In the House, original cosponsors are Representatives Jim Langevin (D-RI), David Cicilline (D-RI), Chellie Pingree (D-ME), Michael Michaud (D-ME), Eliot Engel (D-NY), and Eleanor Holmes-Norton (D-DC).

At this point, our job is to get more cosponsors on the bills.  Once we have copies of the introduced versions of the bills, with bill numbers and original cosponsors listed (which should be next week), we will send them out so that you can forward them to your Members of Congress and ask for their support.  By the way, even if a Member declined to become an original cosponsor, he/she might be willing to become a cosponsor now. 

The more cosponsors there are on these bills, the greater the chances that the legislation will ultimately enacted as part of a larger bill.  Speaking of which...

Payroll-tax/doc-fix bill.  We were hoping -- but not expecting -- that a provision to extend F2F funding (same as the Menendez and Pallone bills) might be included in the large bill to extend the payroll-tax holiday, unemployment insurance payments, and the Medicare "doc fix."  We had hoped that a final compromise on this package might be put off for another couple of months to give us more time to try to get our provision included.  In an unusual development, though, Congress reached a compromise in a timely fashion (even before the last possible minute!), and the resulting bill does not include an F2F funding provision. 

For various reasons, the F2F funding bill is not the type of legislation likely to pass as a stand-alone bill.  This means that we will have to find another "must-pass" legislative "vehicle" on which our provision can hitch a ride.  Opportunities may arise in the lame-duck session of Congress after the election, or early next year.  (Remember, the last F2F extension, in the Affordable Care Act, was not enacted until March, nearly six months into the fiscal year after the funding expired.) 

Also of interest -- To help pay for the Medicare "doc fix" and other health provisions that cost money in the just-passed payroll-tax, etc., legislation, Congress took $5 billion (over the next ten years) from the Prevention and Public Health Fund that was created and funded by the ACA.  As we understand it, the Fund will ultimately grow to the amount originally slated for it, but at a slower pace, and the Fund should still provide about $13 billion over the next ten years. 

President's budget.  Some of you may have been alarmed to find out that the President's budget did not include funding for the F2F program.  This was not a surprise and should not be of great concern.  The President's budget showed no spending for F2Fs in FY 2013 because, by law, the program's funding ends at the end of FY 2012.  It would have been possible for the President to propose new legislation to extend funding, but despite some efforts, this did not happen.  The President's budget, though, is simply a proposal to Congress.  Congress will develop one-year appropriations bills and other legislation (e.g., changes to Medicare, Medicaid or other mandatory spending programs, like F2Fs) that will determine government spending for the coming fiscal years.  While it would have been helpful to have the administration's active support for the F2F program, Congress holds the key to its future (which is why it is so important to get more cosponsors for the F2F funding bill!). 

Title V block grantThe President's budget proposal for FY 2013 included $640 million for the Title V Maternal and Child Health Services Block Grant -- a cut of less than 1% from the FY 2012 congressionally appropriated level of $645 million (although the administration ultimately redirected about $5 million of that funding for the President's HIV/AIDS initiative.)  Family Voices concurs with AMCHP in supporting an appropriation of $645 million for the block grant in FY 2013. 

Supreme Court amicus brief.  As reported last week, Family Voices joined former Surgeon General David Satcher and a number of other organizations in an amicus ("friend of the court") brief to the Supreme Court on the issue of the Medicaid expansion mandated by the Affordable Care Act.  That expansion provides that all individuals with family incomes up to 133% of the Federal Poverty Level will be eligible for Medicaid beginning in 2014. 

The 26 states challenging the ACA have argued that the Medicaid expansion unconstitutionally "coerces" states to implement the provision.  It is this argument that the brief addresses.  Specifically, the brief describes the importance of congressional authority, under the constitution's "spending clause," to put conditions on funds that it provides to the states.  If the Court were to restrict Congress' power to do so, a number of federal programs would be significantly affected.  Background information and a link to the brief can be found at http://bazelon.org/In-Court/Current-Cases/Florida-v.-HHS.aspx.

The National Health Law Program (NHeLP) has also filed an amicus brief in support of the Medicaid expansion, joined by a number of health and long-term care organizations.  The NHeLP amicus brief is available here.

The states have also challenged the ACA's mandate that individuals have health insurance, among other aspects of the law.  The Supreme Court will hear oral arguments for and against the ACA on March 26th - 28th. The challenge to the Medicaid expansion is scheduled for March 28th.

President's comments to The Arc.  On February 10, there was a special gathering at the White House for 150 leaders of The Arc from across the country.  They met with senior White House officials at a Community Leaders Briefing to ask questions and discuss issues facing people with intellectual and developmental disabilities.  Surprise appearances were made by the President himself, as well as his Chief of Staff, Jack Lew.  The Arc's description of the event, and links to some of the President's remarks can be found at http://www.thearc.org/page.aspx?pid=3500&srctid=1&erid=2422977&trid=929aee35-df4d-477d-99dd-0b1ed07a7cd3.


As always, please feel free to contact us with any questions.  Happy Friday!


Brooke Lehmann, MSW, Esq.

Janis Guerney, Esq.