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The Arc on House Health Care Bill: “Medicaid Will Be Decimated”

/in , , /by The Arc

Washington, DC – The Arc released the following statement on the draft legislation that repeals the Affordable Care Act (ACA) and pays for it by decimating Medicaid, a program critical to the lives of people with intellectual and developmental disabilities:

“This legislation ends Medicaid as we know it. If it is enacted, Medicaid will no longer be a state and federal partnership – the federal government will cap what it provides, leaving the states to pick up the pieces. It will have a dire impact on the lives of people with intellectual and developmental disabilities who rely on Medicaid and the Affordable Care Act for their health care, community supports, and as a way to live independently in their communities.

“Thanks to the Medicaid expansion under the Affordable Care Act, millions of people, including people with disabilities, their family members, and their support professionals, have gained access to health coverage. Lives have been saved because people have had access to affordable, comprehensive health coverage. The tax credits and changes to health savings accounts proposed in this bill are not adequate to meet needs of people with intellectual and developmental disabilities or those with chronic health conditions. And we have no idea how much this approach will cost, or how many people will lose coverage as Congress is rushing this bill through before the budget experts can do the math on the price tag in dollars and impact on lives.

“The bottom line is that under this legislation, Medicaid will be decimated. People will lose vital benefits and services that support their basic human right to a life in the community. It will turn back the clock on the progress we have made as a society over the last 65 years. It’s morally reprehensible, and our nation cannot let this happen,” said Peter Berns, CEO of The Arc.

The Arc advocates for and serves people with intellectual and developmental disabilities (IDD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 650 chapters across the country promoting and protecting the human rights of people with IDD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

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Chapters of The Arc Are Getting Media Coverage on the ACA and Medicaid

/in /by The Arc

Members of Congress are constantly seeking ways to know what’s going on back home and what their constituents care about. One way their offices do this is by monitoring their local and state newspapers every day. When constituents get published or quoted, members of Congress and their staff pay attention.

Several chapters of The Arc have gotten such well-deserved attention in the last several weeks. They have clearly and persuasively articulated the concerns of thousands of people with intellectual and developmental disabilities (IDD) in their communities regarding the Affordable Care Act (ACA) and the Medicaid program.

David Thielen, CEO of The Arc of East Central Iowa, had a guest column printed in the Iowa Gazette at the end of December regarding the effects of block granting Medicaid. He made the point that there are only three main levers when costs are shifted to cash-strapped states under a block grant – reducing eligibility, limiting services and supports, and cutting reimbursement to providers. Three weeks later, he followed up with another guest column published in the Cedar Rapids Gazette explaining the tangible benefits of the ACA to individuals with IDD. These include improvements to long-term supports and services, tax credits to improve affordability of health insurance, banning discrimination based on pre-existing condition, ending annual and lifetime caps, and requiring plans to provide a comprehensive set of benefits including rehabilitative and habilitative services and devices.

Robert Hage, President of The Arc of New Jersey wrote a letter to the editor on January 15 that appeared in five local news outlets. He discussed the increased access to private insurance and Medicaid expansion provided by the ACA, and noted that “repeal may make a good soundbite – but what Americans with IDD need now is more than talk – they need action that keeps the promise of the ACA.”

Three other chapters were interviewed in news stories in January, including a television interview. Nancy Murray of The Arc of Greater Pittsburg at ACHIEVA was quoted in the Pittsburgh Post-Gazette regarding Medicaid block grants, “Right now, [this] is the No. 1 concern among disability advocates. We are scared to death.” In an article in the Wisconsin State Journal, Lisa Pugh of The Arc Wisconsin reinforced the few, stark options that states would face under a block grant, “Any form of a reduced funding structure from the federal government means likely one of three things: cuts to programs, cuts to benefits, or elimination of certain populations of people in Medicaid.”

Heather Denman, Executive Director of The Arc of Harrison and Rockingham, appeared in a segment on Virginia’s WHSV 3 to highlighted the ACA’s provisions on ending annual and lifetime caps on health insurance coverage, eliminating pre-existing condition discrimination, and providing funding for services outside of institutions. “The biggest piece is just taking something away and not having anything that is there to replace it and worrying about people who have preexisting conditions,” she stated.

The Arc is proud of its network of over 660 chapters across the country who work hard everyday advocating for people with IDD and their families. We are pleased to see more and more in the press as a result of this as informed and passionate spokespersons.

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The Arc on the ACA: “For People With Disabilities This Is a Matter of Health, Independence, and So Much More”

/in /by The Arc

Washington, DC – As the U.S. Senate passed a budget resolution that begins the process of repealing the Affordable Care Act (ACA), The Arc released the following statement and background information on why the law is critical for people with intellectual and developmental disabilities (IDD):

“Repealing the ACA without a replacement turns back the clock to a time when too many people with disabilities were discriminated against in the health insurance market. For those who were lucky enough to find affordable coverage, many were faced life and death care decisions because of arbitrary financial limits under those plans, or were stuck with service or support options that segregated them from the community.

“All people with disabilities need comprehensive, affordable care – the ACA took our country a giant step forward toward accomplishing this goal. The Arc has long supported expanding Medicaid coverage to adults and raising the income eligibility. Due to those changes, millions of Americans, including people with disabilities, gained access to affordable, comprehensive health care.

“This is about people’s lives – their health, independence, financial stability, and so much more. The clock is ticking for millions of Americans, including people with disabilities,” said Peter Berns, CEO, The Arc.

The ACA made significant progress in expanding access to health care for individuals with IDD. The ACA allowed states to extend their Medicaid programs to childless adults earning up to 138% of the federal poverty level. This change has provided coverage to individuals with IDD and other disabilities and chronic health conditions who were not otherwise eligible for Medicaid, were in the waiting period for Medicare, or did not have access to employer sponsored health insurance because they were not working or working in low wage jobs without benefits.

  • The ACA provided federal money to support Medicaid expansion. The additional federal contribution to expanding Medicaid has helped many people with disabilities access health care. It has also enabled states to continue and expand programs that provide supports and services to people with IDD.
  • Several provisions of the ACA were designed to assist states to rebalance their long term supports systems, allowing more people with IDD to receive the services and supports they need while living in the community instead of costly and outdated institutions. These include the Community First Choice Option (CFC) and the State Plan Home and Community-Based Services Option (also known as 1915(k) and 1915(i).
  • The ACA reversed years of discrimination against people with disabilities and chronic health conditions through its insurance reforms. Prior to the ACA, when people with disabilities or chronic health conditions tried to purchase health insurance in the individual market they often could not obtain coverage at all because of their pre-existing conditions; others faced sky high premiums, or were only granted very limited coverage.

Learn more from The Arc’s ACA fact sheet, and sign up for our Disability Advocacy Network to know when to take action when it matters the most.

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Supreme Court Delivers Major Victory Against Housing Discrimination

/in /by The Arc

This week, the U.S. Supreme Court issued several landmark decisions for all Americans, including people with intellectual and developmental disabilities and their families.

In a 6-3 opinion in King v. Burwell, the Supreme Court held that federal tax subsidies are being provided lawfully in those states that have decided not to run the marketplace exchanges for insurance coverage. This is a huge win for the Affordable Care Act and people with disabilities throughout the country.

Less prominent, but a tremendous victory for civil rights, is the Supreme Court’s 5-4 decision in Texas Department of Housing and Community Affairs v. Inclusive Communities Project, Inc., a ruling that will support the continued progress of people with disabilities and other minorities toward full inclusion in all aspects of American life.

In this case, the Supreme Court ruled that housing discrimination is illegal, even if it is not intentional. This decision upholds a longstanding principle under the Fair Housing Act, known as “disparate impact.” By finally settling the question of whether the language of the Fair Housing Act allows for claims based on disparate impact, as the Civil Rights Act of 1964 does, the decision supports our nation’s progress toward integrated, inclusive communities that foster opportunities for all Americans.

In the case, a fair housing advocacy organization sued the state of Texas, alleging violations of the Fair Housing Act for awarding federal tax credits in a way that kept low-income housing out of predominantly white neighborhoods, thereby denying minorities access to affordable housing in communities where they might access better schools and greater economic opportunity. The state was not accused of intentionally excluding African-Americans from predominantly white neighborhoods, but of structuring its tax credit assignments in such a way that they had a discriminatory effect.

At stake in this case was not only the claims brought against the state of Texas, but also whether the key legal protections provided under disparate impact would continue to be available under the Fair Housing Act.

As noted in the Supreme Court’s majority opinion, Congress enacted the Fair Housing Act of 1968 following the assassination of Dr. Martin Luther King, Jr. “to eradicate discriminatory practices within a sector of the Nation’s economy.” As amended, today the Fair Housing Act prohibits discrimination in housing on the basis of disability, race, national origin, religion, gender, and familial status.

Disparate impact is a legal doctrine that holds that the Fair Housing Act and other civil rights laws prohibit policies and practices that discriminate, whether or not the policies were motivated by the intent to harm a particular group.

For over 40 years, the disparate impact doctrine has been a key tool protecting the rights of people with disabilities, people of color, and other groups covered by the Fair Housing Act and other civil rights laws to have equal opportunity to live and work in the communities that that they choose. It has formed the basis for federal regulations and has been used extensively by the Department of Justice, the Department of Housing and Urban Development, and civil rights organizations to fight housing and employment discrimination across the United States.

The ability to allege disparate impact under the Fair Housing Act has been upheld by 11 federal appeals courts, but the Supreme Court has never before issued an opinion in a fair housing disparate impact case.

Fortunately, a majority of the Supreme Court upheld the disparate impact standard, finding that recognition of disparate impact claims is consistent with the Fair Housing Act’s central purpose.

This week’s decision marks an important milestone in our nation’s path toward integration and inclusion. It’s a major victory that shores up the progress that people with disabilities and civil rights organizations have made over the last four decades, and strengthens our ongoing work to end discrimination in all its forms.

To learn more:

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The Arc Applauds Supreme Court Ruling Upholding Subsidies to Purchase Health Insurance Under the Affordable Care Act

/in /by The Arc

Washington, DC – In its 6-3 King v. Burwell decision, issued today, the U.S. Supreme Court held that federal tax subsidies are being provided lawfully in those states that have decided not to run the marketplace exchanges for insurance coverage. This is a huge win for the Affordable Care Act (ACA) and people with disabilities throughout the country.

The case was brought by Virginia plaintiffs alleging that the ACA forbids the federal government from providing subsidies in states that do not have their own exchanges. These exchanges allow individuals without insurance to shop for individual health plans. Some states created their own exchanges, but others allowed the federal government to run them. Approximately 85% of individuals using the exchanges qualify for subsidies to help pay for coverage based on their income.

“Today’s Supreme Court ruling upholding the subsidies to purchase health insurance in the federal exchanges is good news for many Americans, including people with intellectual and developmental disabilities. This challenge could have weakened the law overall, threatening all the protections that people with disabilities gained in the landmark law. This ruling should end the effort to dismantle this law, and instead the focus should be entirely on effective implementation,” said Peter Berns, CEO of The Arc.

The ACA is important to people with disabilities. It expanded coverage and reformed insurance to end discrimination against people with disabilities and enhance access to health care. The private health insurance marketplaces allow individuals or small businesses to shop for coverage and potentially receive subsidies to help offset the cost of insurance. The subsidies are key to ensuring affordable coverage. The health insurance reforms, the protections from high premium increases or out-of-pocket costs, and the coverage of “essential health benefits,” including mental health care and rehabilitative/habilitative services and devices, help assure that people with disabilities have affordable health care that meets their needs.

The Arc advocates for and serves people with intellectual and developmental disabilities (IDD), including Down syndrome, autism, fetal alcohol spectrum disorders, cerebral palsy, and other diagnoses. The Arc has a network of more than 665 chapters across the country promoting and protecting the human rights of people with IDD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

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Affordable Care Act Update: What You Need to Know About Open Enrollment

/in /by The Arc

If you are uninsured or looking for affordable health insurance, now is the time for you to look! During “open enrollment” you can purchase private health insurance through the marketplace in each state. Depending on your income, you may be eligible for assistance with your health insurance costs.

If you currently have insurance through the marketplace, you should look at your current plan and determine if it will continue to meet your needs, or select a better plan. If you do not take action, you will be automatically re-enrolled in your current plan. Re-enrollment provides an important opportunity to report any changes to your income.

  • November 15, 2014: 2015 open enrollment begins
  • December 15, 2014: Enroll before this date to have coverage January 1, 2015
  • February 15, 2015: Open enrollment ends

Why you should check your coverage:

  • Even if you like your health plan, new plans may be available and premiums or cost sharing may have changed since last year.
  • Even if your income has not changed, you could be eligible for more financial assistance.

If you have a disability or a health condition, pay attention to possible changes:

  • Are a broad range of health care providers included in the health plan’s network of providers?
  • Are there enough medical specialists in the network to meet your needs?
  • Are needed medications included in the plan’s list of covered drugs?
  • Is there adequate access to non-clinical, disability-specific services and supports?
  • Does the plan have service limits, such as caps on the number of office visits for therapy services?
  • Are mental health services covered to the same extent that other “physical” health benefits are covered?

Where to get help?

Health insurance can be complicated. If you or your family member needs assistance with understanding the options, healthcare.gov can help. This website has information about seeking assistance in local communities, explanations of health insurance terms, enrollment information and much more. There is also a 24-hour phone line for consumer assistance at 1-800-318-2596 to call for help.

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A New Affordable Care Act Resource

/in /by The Arc

The Arc is excited to be part of the National Disability Navigator Resource Collaborative (NDNRC) a new resource for people helping the uninsured to gain coverage through the health insurance marketplaces. The collaborative is led by the American Association on Health and Disability (AAHD) and is supported by a one-year grant from the Robert Wood Johnson Foundation.

The Collaborative intends to develop training and technical assistance materials to respond to the need for cross disability training for people who are helping with the enrollment process. The Collaborative will address issues particularly important to people with disabilities such as the interplay between the private marketplaces, Medicaid and Medicaid alternative benefit plans, the need to carefully compare plans especially in the rehabilitation and habilitation benefits, the pharmacy benefits and mental health and substance abuse parity.

The funding for this project is scheduled to begin this week and the first meeting of the advisory organizations will take place in late October. The Arc recognizes the critical need for this work and looks forward to being a part of the effort.

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Reject Piecemeal End to the Government Shutdown and Protect People With Disabilities

/in /by The Arc

Washington, DC – The Arc calls on Congress to reject the piecemeal approach to ending the government shutdown and urges lawmakers to put an end to the Federal Government shutdown immediately for all Americans.

“People with intellectual and developmental disabilities rely on numerous federal government programs to live, learn, and work in their communities. We cannot allow Congress to cherry pick which federal programs continue operations based on arbitrary criteria. We are all in this together,” said Marty Ford, Senior Executive Officer, Public Policy, The Arc. “Congress must adopt appropriations legislation now that does not lock in the harmful, low spending levels from the sequester or defund or delay the Affordable Care Act.”

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The Arc Reacts to Approval of Deal to Avert “Fiscal Cliff”

/in /by The Arc

Washington, DC – The Arc released the following statement as the Congress approved a deal to avert going over the “fiscal cliff” – the series of harmful tax increases and spending cuts which Congress and the White House have been seeking to avoid for several weeks. With time running out, The Arc’s advocates had encouraged Congress to act before the deadline to protect disability related programs and extend tax cuts for the middle class.

“The Arc appreciates the Administration’s outreach to Congress to get this legislation passed so that middle class families with people with disabilities don’t see their income taxes rise in the New Year. Most people with intellectual and developmental disabilities and their families cannot afford a tax increase and this deal protects them. They also cannot afford cuts to critical programs and this legislation does not include such cuts.

“Throughout these tense weeks of negotiation, there were proposals on the table that would have greatly harmed people with intellectual and developmental disabilities (IDD), including a new way of calculating Social Security benefits known as the ‘chained CPI’ that would have impacted the ability of millions of people with IDD and other disabilities to be as independent as possible. This threat was excluded in this piece of legislation, as were harmful changes to Medicaid, a lifeline to people with IDD.

“Going into 2013, there will continue to be mounting pressure to generate additional revenue and to find additional cuts in the federal budget to reduce the deficit further, including the Medicaid, Medicare, and Social Security programs. The Arc’s advocates will be vigilant, putting pressure on Congress to protect these lifeline programs.

“The final legislation does include a repeal of the CLASS Act, a part of the Affordable Care Act to address access to costly long term services and supports in our society. We are deeply disappointed that this framework for solving a critical problem was repealed. However, we look to the Commission created in the legislation to work expeditiously to determine next steps to address this problem, including consideration of the needs of people with IDD,” said Peter Berns, CEO of The Arc.

Additional legislation will be necessary to address other aspects of the nation’s fiscal situation in the next three months, including an increase in the debt ceiling, the end of the 2-month extension included in this legislation of the sequester (automatic cuts), and appropriations for the remainder of Fiscal Year 2013. These deadlines will set the stage for additional negotiations between the Congress and the White House. The Arc will be working hard during these negotiations to preserve programs that are vital to people with IDD.

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The Affordable Care Act: What Disability Advocates Need to Know

/in /by The Arc

Now that the U.S. Supreme Court has affirmed the constitutionality of the Affordable Care Act (ACA), the disability community must work to better understand the law and the many benefits it can provide to people with disabilities. This will be critical to the community’s role in helping to move states forward with implementation.

Numerous ACA provisions related to both acute care and long term services and supports hold great promise for improving the health and wellbeing of people with disabilities. The Arc’s national public policy team has put together this analysis to provide information about the major provisions and the status of their implementation.

This analysis was previously shared with those who are signed up for our Action List. Want to get involved with The Arc’s legislative advocacy?

If you require a Word version of this document, please contact Kristen McKiernan, McKiernan@thearc.org.