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RCPA received the following email from the Senate Aging Committee in Washington, DC. Please contact both Senators Casey and Toomey and your Congressman.

“Welcome back to health care by way of a tax bill.

This afternoon both the Senate and the House added to their tax bills a provision to repeal a key component of the Patient Protection and Affordable Care Act, the individual mandate to obtain health insurance. Repealing this provision would have significant negative effects for people with disabilities, families of children with disabilities, and those who are aging.

  • Repealing the individual mandate will mean 13.8 million people will lose health care coverage (according to an analysis by the Congressional Budget Office); hundreds of thousands of those individuals have disabilities).
  • The repeal of the individual mandate will increase health insurance premiums for those purchasing coverage on the exchange by at least 10% per year for the unforeseeable future (also according to an analysis by the Congressional Budget Office); these premium increases will occur in addition to the increases that are occurring because the executive branch has decided to stop supporting cost sharing reduction (CSR) payments that have driven premiums up by an average of over 20% this year.
  • The repeal of the individual mandate will save approximately $330 billion over ten years that will go toward paying for a cut in corporate taxes and a cut to the tax rate for the most wealthy Americans (according to the CBO).

This new, last minute, major addition to the tax bills will have enormous impact on those with disabilities. In combination with the budget that passed three weeks ago and outlines over $1 trillion in cuts to Medicaid and over $400 billion in cuts to Medicare, the proposed tax cuts and repeal of key provisions of the ACA will increase demand for Medicaid, decrease the funds available for home and community-based services and supports, and reduce the amount of revenue available to states to pay and support Medicaid.

While the tax bill does not directly cut Medicaid, the actions it takes will have the same or even worse effect on Medicaid and other services and supports for people with disabilities. If the House tax bill were to pass:

  • Deductions for medical expenses could not be used to decrease your taxes;
  • It would eliminate a $2,400 tax credit businesses could get when hiring someone with a disability;
  • It would eliminate a $5,000 tax credit for businesses that make their businesses accessible to people with disabilities;
  • It would eliminate the incentive to contribute to nonprofit agencies that often provide support for people with disabilities and their families; and
  • It would remove a tax credit for companies to develop and manufacture orphan drugs.

The assault on people with disabilities and their families is continuing, this time through a tax bill instead of through a health bill. And this is happening quickly with very little coverage. The Senate Finance Committee will likely vote on this bill Thursday or Friday of THIS week.

You can help by:

  • Contacting your Senators and Representatives and telling them the tax bills being considered are an attack on people with disabilities; and
  • Share this information with friends and family.

Thank you for your continued advocacy. Thank you for working to ensure dignity, independence, and economic sufficiency for people with disabilities.”

Questions, contact Jack Phillips, RCPA Director, Government Affairs.

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On October 26, 2017, the Energy & Commerce Committee and the Ways and Means Committee announced in a press release that they have come to a policy agreement on a permanent repeal of the Medicare therapy caps. The policy/discussion draft will repeal the therapy caps, continue to require an appropriate modifier is included on claims submitted over the new threshold (indicating the services are medically necessary), and continue targeted medical review of claims established by the Medicare Access and CHIP Reauthorization Act (MACRA).

Background:
In 2006, Congress created an exceptions process allowing patients to exceed the cap based on medical necessity. The cap was addressed most recently in 2015 with MACRA (H.R. 2), becoming law. A provision in H.R. 2 established targeted medical review of therapy caps and extended the therapy cap exceptions process until January 1, 2018.

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The means 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.

RCPA requests members to contact Senators Casey and Toomey, and ask them to OPPOSE the Graham/Cassidy bill. For your convenience, the following materials will give you valuable information and talking points when speaking with staff or the Senators.

Questions, contact Jack Phillips, RCPA Director, Government Affairs.

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Please join Sen. Bob Casey (PA) as he addresses the Graham-Cassidy proposal and the effects on Medicaid, adults with disabilities, children with complex health needs, schools, veterans, and those who are aging. Details for joining below:

What: Conference call with Sen. Bob Casey
When: Friday, September 22, 5:45 pm–6:15 pm EDT
Call in number: 866-317-5076, no PIN or ID necessary
No RSVP necessary

Questions, contact Jack Phillips, RCPA Director, Government Affairs

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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

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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.

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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.

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