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Federal

0 2023

ALERT – Act Now to Stop Irreparable Medicaid Cuts!
Latest Available data on Graham/Cassidy

The next few days are critical!
Call Congress at (202) 224 3121 and
click here to send your Senators an email to VOTE NO.

The process by which Senate Republicans can pass an Affordable Care Act (ACA) repeal/replace bill by a simple majority budget process called reconciliation (and thus not requiring Democratic support of any kind) ends next week, at the end of September.

The Graham/Cassidy bill is now presenting a major threat to Medicaid – it replicates cuts presented in previous health proposals (using exact language from the Better Care Reconciliation Act – BCRA). According to earlier Congressional Budget Office (CBO) estimates, it will cut Medicaid (outside of expansion) by $175 billion between 2020-2026, and $39 billion will be cut from the Medicaid program in 2026 alone.

The situation has gotten worse. Last night, Chairman Alexander (R-TN) of the Senate HELP Committee who was leading bipartisan ACA fix efforts announced that the bipartisan deal is dead. That leaves the door wide open for Graham/Cassidy passage. Republican Senators are being told that the bill will benefit their state – that is false. This is a bill that seeks to save billions of federal dollars, not make policy improvements to health care programs.

The ACA will be replaced by block grants with likely less funding to states than they currently receive. and all of that money stops flowing completely to states in 10 years. The Medicaid program will be cut significantly and states will be expected to either pick up the bill or make tough decisions about whose lives are most at stake.

So here’s the timeline:

There are two Jewish holidays in the next two weeks that shorten the Senate session calendar. Today, Senators leave to observe Rosh Hashanah and will return Monday. They will have to pass a bill by Wednesday or Thursday because Yom Kippur (also observed by the Senate) begins at sundown next Thursday.

We will soon see a new Congressional Budget Office summary on the impact of Graham/Cassidy, and we expect the bill to be pushed hard next week to get to passage. We need three Republican Senators to oppose the bill in order for it to fail. Key Senators that could stop the bill are the same champions that ANCOR has awarded Congressional Leadership Awards to this year for defending our programs – Senator McCain (R-AZ), Senator Collins (R-ME), and Senator Murkowski (R-AK). Please make sure that if you are a constituent, or have connections in their states, that they hear from you!

IF YOU LIVE OR HAVE FRIENDS, FAMILY, OR COLLEAGUES IN STATES WITH REPUBLICAN SENATORS THEY MUST HEAR FROM US THAT THE GRAHAM/CASSIDY BILL WILL CREATE IRREPARABLE HARM TO PROGRAMS THAT PROTECT PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES!

THE NUMBERS ARE CLEAR THAT THIS IS A BAD DEAL FOR STATES! MAKE SURE YOUR REPUBLICAN REPRESENTATIVES IN THE HOUSE ARE RECEIVING THE SAME MESSAGE!

Capitol  Switchboard: (202) 224-3121

Graham/Cassidy Text

  • Medicaid per capita cap section begins Section 124, page 65
  • Provider tax reduction is Section 123, page 64
  • Penalization to states that overspend, page 66
  • Per capita formula base period, page 68
  • Per capita formula inflation rate (CPI-M+1% until 2026 then CPI-M), page 76

Limited HCBS demo (we have intel this is for fear that per capita caps will end some state HCBS programs and need demo money to survive), page 96

0 2305

The Federal Department of Labor (DOL) is seeking comments from the public concerning the Fair Labor Standards Act (FLSA) overtime exemptions regulations. As you may recall, the Obama Administration wanted to increase the overtime threshold from $23,660 to $47,476. At the time, RCPA submitted comments to the Department of Labor objecting to the increase. RCPA also presented testimony in front of the Pennsylvania State Senate regarding the impact that the DOL’s Overtime Exemption Rule would have on health and human service providers in Pennsylvania.

Before the rule took effect, a federal judge issued an injunction halting the FLSA rule. The judge granted the injunction because the FLSA rule “exceeded its delegated authority and ignored Congress’ intent such that it supplants the duties test.” (The duties test refers to one of the conditions that determines which workers are exempt from overtime rules.)

You may submit comments on the Federal Register’s website. Questions, contact Jack Phillips, RCPA Director of Government Affairs.

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A new Request for Information (RFI) has been released by the US Department of Labor. This RFI pertains to the overtime rule that defines those employees exempt from the minimum wage and overtime requirements of the Fair Labor Standards Act. In order to gather information to consider when deciding if and how to revise the regulation, the agency is requesting comments from the public.

0 2123

This weekend, Senator McConnell announced that there would be no vote on the BCRA this week, and the Congressional Budget Office (CBO) announced that there would not be a score of the BCRA, either. Additionally, the State Senate is scheduled to return today in the midst of a possible state budget action. Because of this, Wednesday’s press conference is being postponed.  We will keep you updated on future events.

RCPA has been working with a multi-association group to oppose the federal proposed American Health Care Act (AHCA)/ Better Care Reconciliation Act (BCRA). We previously sent a letter to Senators Casey and Toomey and are now planning a letter to the editor and press conference. The effort has been led by the Hospital and Healthsystem Association of PA (HAP), but has been a very collaborative initiative, and RCPA will be speaking at the press conference along with several other associations. We encourage you to attend this event which is being held at the Capitol in Harrisburg on Wednesday, July 19 at 11:00 am. For additional information contact Jack Phillips, Director of Government Affairs.

0 2649

nc-action-alert

The Senate has released its version of the American Health Care Act and it is worse than we feared. The Senate bill will cut Medicaid even more than the House bill in the future, putting tremendous pressure on safety-net services and providers.

But there is still time to act! The Senate is gearing up for a vote in the coming days, so NOW is the time to speak up and protect Medicaid.

unite-4-bhTaking action is easy:

  1. Dial this number: 202-224-3121
  2. Ask for your Senator.
  3. Share with them this message:
    • Your Message: I am calling to ask the Senator to vote NO on the Better Care Reconciliation Act. Cutting Medicaid and rolling back the Medicaid expansion will have a devastating effect on people with mental illnesses and addictions who rely on Medicaid for lifesaving treatment. Please vote NO. I’m calling from [city, state, and zip] and my name is [first and last name].
  4. Call your other Senator and share the same message!

Thank you to all who have taken action on this issue so far this year. We appreciate your hard work and dedication and ask that you continue to mobilize and advocate on this critical issue! Together, we can protect and preserve Medicaid for millions of Americans in need.


 

Questions, contact Jack Phillips.

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Until today, it was hard to imagine a bill could be worse for Americans living with addiction and mental illness than the AHCA bill passed last month by the House of Representatives.

The Senate version of the American Health Care Act purports to be a “repeal and replace” of the Affordable Care Act, but is really a draconian restructuring and gutting of Medicaid, the program that covers 20% of Americans and is one of the primary payers of addiction and mental health treatment in the U.S.

Instead of “repeal and replace,” it is “wreck and wreak havoc.”

The bill’s supporters have said that their newest proposal would “soften the landing” for Americans who will lose Medicaid coverage. In reality, the landing would be catastrophic. There is nothing “soft” about ripping health care away from the 11 million Americans enrolled in the Medicaid expansion. The new bill also shifts hundreds of billions of dollars in costs to states—leaving them with a Sophie’s Choice of which populations and benefits to cut in order to close their budget shortfalls. Seniors? Pregnant woman? People with a preexisting condition, like cancer or a heart attack? Who do we help, and who do we turn our back on?

The Senate bill also slices and dices Medicaid enrollees into the deserving and the undeserving, exempting some populations with disabilities from the caps while leaving other vulnerable individuals—like people with addictions—out in the cold. Lawmakers must remember that people with addictions do not qualify as “disabled” under a Gingrich-era change that excluded them from Social Security Disability. The proposed cuts to Medicaid would disproportionately harm those who rely on Medicaid for lifesaving opioid addiction treatment, at a time when mortality from the opioid epidemic is growing at devastating speed each year. We are facing a national emergency on opioids – now is hardly the time to reduce our efforts.

The bill’s feeble attempts to bolster psychiatric treatment while stripping health care away from millions are paltry at best. While the outdated law prohibiting Medicaid funding for services provided in residential or inpatient treatment settings deserves to be changed, the small tweak to this payment exclusion that is included in the bill will do nothing to mitigate the loss of Medicaid coverage for millions—nor does it provide for important outpatient care serving people in their own communities. The proposed one-year grant fund for mental health and addiction treatment in 2018 doesn’t come close to meeting the real—and growing—need for care. Grants are not a substitute for health coverage. We don’t rely on grants for the treatment of heart disease or cancer, and addiction and mental health should be no different.

Congress has made incredible strides in advancing access to care for mental illness and addiction in recent years. It is shocking that members of Congress – many of whom have family members who would be affected and all of whom represent constituencies who would be gravely harmed – would even consider a bill that would obliterate these gains, returning us to the days when people with mental illness or addiction couldn’t access treatment.

This is not our vision for America. Slashing billions of Medicaid dollars from state budgets would cost hundreds of thousands of lives. The National Council urges the Senate to vote down this reprehensible bill.

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The National Council for Behavioral Health is the unifying voice of America’s community mental health and addictions treatment organizations. Together with 2,800 member organizations, it serves more than eight million adults and children living with mental illnesses and addiction disorders. The organization is committed to ensuring all Americans have access to comprehensive, high-quality care that affords every opportunity for recovery and full participation in community life. The National Council, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health pioneered Mental Health First Aid in the U.S. and has trained more than 1 million individuals to connect youth and adults in need to mental health and addictions care in their communities. To learn more about the National Council, visit the official website.