March 8 Washington Update
Greetings from Washington. This week's update includes some more federal budget-related news (sequester effects, appropriations) and a few miscellaneous pieces of information.
Federal budget: the sequester and appropriations. As reported last week, the infamous "sequester" went into effect on March 2, resulting in $85 billion in automatic across-the-board cuts in FY 2013 federal spending for every "program, project and "activity." Under the law mandating the sequester, agencies have very little discretion about what can be cut.
As explained last week, half of the sequester cuts will come from defense spending, and half will come from domestic spending, but some important programs are exempt from any cuts, including Medicaid, food stamps (SNAP), and Social Security. Medicare provider payments will be cut 2% on an annualized basis. Cuts in domestic discretionary spending (e.g., special education, medical research, housing, child care, and mental health treatment) will be reduced by 5 percent on an annualized basis. Since we are already five months into the fiscal year, these programs will be cut approximately 9 percent for the next seven months if no reductions have been made by the administering agencies to date.
Although some sequester effects may not be felt for a while, other cuts, or anticipated cuts, are already having a significant impact on low-income people and others -- including people with special health care needs -- who depend on government programs such as those providing housing aid, special education and mental health services. See this New York Times article: As Automatic Budget Cuts Go Into Effect, Poor May Be Hit Particularly Hard. According to an article in "DisabilityScoop," administration projections show that about $600 million will be cut from the special education programs this year, putting the jobs of 7,200 teachers, aides and other staff at risk. Another result of the sequester might be a substantial growth in the backlog of Social Security disability claims, according to a White House fact sheet.
For an article about how the sequester would affect various health programs, see http://www.kaiserhealthnews.org/stories/2013/february/20/sequester-health-cuts.aspx. For White House information on how various federal programs will be affected in each state, see http://www.whitehouse.gov/blog/2013/02/22/what-sequester#states.
F2F funding and the sequester. The funding for Family-to-Family Health Information Centers (F2Fs) falls within the category of domestic mandatory, rather than discretionary, spending. The OMB has calculated that, in general, domestic mandatory spending programs will be cut by 5.1 percent on an annualized basis. Since FY 2013 funds have not yet been used for F2F grants, these cuts would be spread over twelve months, so should not be greater than 5.1 percent. However, the sequestration calculations are extremely complicated, and there are some variations within categories, so only HRSA will be able to provide a definitive answer on the cuts to F2F funding.
What next? Two related processes are underway - an effort to end the sequester through the negotiation of a "grand bargain" (or even a "petite" bargain, as one lawmaker put it), and an effort to reach agreement on appropriations legislation to keep the government running after March 27. That's the expiration date of the current "continuing resolution," which is basically an extension of funding levels from the last fiscal year.
On Wednesday, the House passed a bill to continue funding government operations after March 27. See "House passes bill to avert government shutdown in March." The Senate is expected to take up the House next week, but to make significant amendments being developed on a bipartisan basis. Both bills would provide some degree of flexibility to the administration to mitigate the effects of sequester cuts on specific programs by shifting around funds within agencies. See "Senate Dems unveil changes to House bill funding government."
Meanwhile, the President has reached out to congressional Republicans in an effort to attain a deal to replace the sequester with deficit reductions achieved from alternative spending cuts (including some from changes to entitlement programs) and revenues, such as those gained from closing tax loopholes. Reportedly, President Obama would like to negotiate a deficit reduction deal by July or August, when the debt limit will need to be increased. See http://thehill.com/homenews/senate/286951-obama-sets-end-of-july-goal-for-bipartisan-deal-on-deficit.
F2F funding legislation. As reported earlier, Representative Frank Pallone (D-NJ) introduced a bill to extend funding for Family-to-Family Health Information Centers through FY 2016 at the current funding level of $5 million per year. We also expect a Senate companion bill to be introduced by Sen. Menendez (D-NJ). If you would like to urge your Representative to cosponsor the House bill (H.R. 564), you can find his/her contact information at www.house.gov.
Forum on Mental Illness and Violence. On March 5, House Oversight and Investigations Chairman Tim Murphy, Ph.D. (R-PA), a psychologist, hosted a bipartisan mental health forum focusing on treatment and research into severe mental illness and violence. Witnesses included parents of individuals suffering from mental illness, who testified about difficulties they have faced in trying to get treatment for their children. Other experts, including Dr. Thomas Insel, Director of the National Institute of Mental Health, discussed barriers to treatment, the effectiveness of federal, state, and local programs, and ways to expand access and improve treatment outcomes. To watch the full forum, click here.
TSA Offers Extra Help For Travelers With Special Needs. The Transportation Security Administration (TSA) has announced that it is deploying specially-trained staffers to assist travelers with disabilities or other special needs during the airport security screening process. According to "DisabilityScoop," the announcement comes just weeks after the agency publicly apologized after an online video of agents mishandling the screening of a 3-year-old in a wheelchair went viral. The TSA "Passenger Support Specialists" are supposed to be able to quickly resolve traveler-related screening concerns. More than 2,600 Passenger Support Specialists have received specialized training on how to assist with individuals with special needs, how to effectively communicate with passengers, and disability etiquette and disability civil rights.
According to a recent update of the TSA website, travelers requiring special accommodations or concerned about checkpoint screening may ask a checkpoint officer or supervisor for a Passenger Support Specialist who will provide on-the-spot assistance. A Passenger Support specialist may be requested ahead of time by calling the TSA Cares hotline at 1-855-787-2227. See also http://www.tsa.gov/traveler-information/travelers-disabilities-and-medical-conditions.
The Health Care Law 101. A presentation on the main provisions in the Affordable Care Act and how to access care in your community will be held in Spanish on March 19 at 3:00 p.m. ET.
Frequently Asked Questions about ACA Implementation. CMS has posted a set of frequently asked questions about Medicaid and CHIP issues related to the ACA, including changes in Medicaid eligibility (under the "Eligibility Policy" category.)
As always, please feel free to contact us with any questions.
Best, Janis & Brooke
Janis Guerney, Esq.
Brooke Lehmann, MSW, Esq.