The State of America’s Direct Support Workforce Crisis 2022
ANCOR’s Government Relations staff distributes stories in the Washington Insiders Club (WICS) – a weekly round-up of top stories and headlines – to ANCOR Members to keep them up to date on policy and political developments of note to the disability community. The following entries highlight the most significant reports of the last two months.
October 6, 2017 — On Thursday October 5, the U.S. House of Representatives passed its 2018 budget resolution, which Democratic Congressional leadership opposed because of projected cuts it contained to Medicaid. This is the first step in the FY18 budget process (usually it occurs earlier in the preceding year). The budget resolution process is expected to become a vehicle for tax reform and has a possibility of directly or indirectly affecting Medicaid.
Budget resolutions can pass by simple majority – they are not legally enforceable instruments, they set the tone and theme for legislative and budget goals for FY18 and in this case, with the GOP in control of Congress, they are largely reflective of GOP principles. The instructions set out in the resolutions can move forward reconciliation bills that are fast tracked in Congress (think healthcare (ACA repeal/replace and Medicaid reform )proposals of 2017 and in 2018 this is likely tax reform).
The steps for the budget resolution and reconciliation process are:
1. The House passes it budget resolution.
2. The Senate passes its own budget resolution – that vote is expected to occur the week of October 16th.
3. Because the Senate proposal has a $1.5 trillion deficit (over 10 years) that conflicts with the House budget, bothchambers will negotiate a final agreement and vote on it.
4. Tax reform legislation text will be shared publicly reflective of the GOP proposal (agreed upon by the White House, Senate, and House)
5. A reconciliation bill with a focus on tax reform will be introduced with a goal of passing it sometime within FY18
A budget reconciliation bill can be introduced to meet the goals and instructions set out by the agreed upon Congressional budget resolution. As a reminder, bills passed under this process MUST be budget-focused (not policy-focused) and only require 51 votes for passage in the Senate instead of the usual 60. Republicans hold the majority of the Senate with 52 votes.
The reconciliation process should look the same for tax reform as it was for unsuccessful attempts to cut and cap Medicaid and repeal the Affordable Care Act this past summer, except that it will be for Fiscal Year 2018 instead of Fiscal Year 2017. That is because the process for 2017 expired on September 30. Click here for our primer on the 2017 reconciliation process.
ANCOR is closely monitoring the tax reform process, because it could it could lead to Medicaid cuts, indirectly or directly. For example, cuts to Medicaid and/or per capita caps could be directly written into the tax legislation to generate savings for proposed tax cuts. Alternatively, cuts to Medicaid could be implemented in future years as a way of indirectly off-setting tax cuts, which are expected to put pressure on federal funds. Both the Tax Policy Center and the Committee for a Responsible Federal Budget say the tax reform proposal as outlined will lead to losses in federal revenue.
We encourage ANCOR members to use this time to educate their legislators on the importance of Medicaid for people with disabilities and remind them what optional programs under Medicaid mean for states making difficult budget decisions.
October 6, 2017 — This week the Administration on Community Living (ACL) announced:
“On September 29, President Trump signed an executive order continuing the President’s Committee for People with Intellectual Disabilities (PCPID) through September 30, 2019.
PCPID is a federal advisory committee which promotes policies and initiatives that support independence and lifelong inclusion of people with intellectual disabilities in their respective communities. The committee includes representatives from several federal agencies and 18 citizen members.
Appointments to the vacant positions on the Committee are expected to be made over the coming months, with the first meeting of the new membership announced shortly thereafter.”
ANCOR members interested in appointments to this Committee should contact Esme Grant Grewal at [email protected].
October 6, 2017 — ANCOR joined 171 organizations in a letter to House Speaker Paul Ryan and House Democratic Leader Nancy Pelosi opposing the ADA Education and Reform Act, H.R. 620. Despite its promising name, the legislation would actually create significant obstacles for people with disabilities to enforce their rights under Title III of the ADA to access public accommodations and would impede their ability to engage in daily activities and participate in mainstream society. Read the full letter and see all signatories here.
October 2, 2017 — On Tuesday, September 26, 2017, Senate Republicans decided to not bring up the Graham-Cassidy-Heller-Johnson bill for a vote. This in effect defeats the harmful bill, which would have imposed significant cuts and per capita caps on Medicaid and repealed and replaced the Affordable Care Act (ACA). Click here for ANCOR’s press statement – and thank you to ANCOR members for their advocacy!
While the bill’s withdrawal means that the Senate GOP can no longer benefit from the 2017 budget process to pass health care reform on a simple majority, ANCOR would like to emphasize that Medicaid is not off the Congressional menu yet. It is important to note that a strong message from some Republicans at Monday’s Senate Finance Hearing was that Medicaid, even the traditional programs, is on an unsustainable path.
During the Finance hearing, these Senators stressed that it makes sense to control Medicaid by a medical inflation rate, and made similar comments in the press conference announcing the bill’s withdrawal, which you can watch here. This means the Graham-Cassidy bill could be revisited at a later date. Alternatively, Medicaid could be discussed in 2018 budget negotiations, which will start soon (though the Senate GOP is sending mixed signals on that possibility). The current Continuing Resolution expires December 8 so a budget deal of some kind will have to be made to fund the rest of FY18. See the possible next steps for the Senate GOP on health care in ANCOR’s infographic here.
ANCOR will continue to be vigilant about bills that could threaten Medicaid and the stability of supports and services for people with disabilities. We will keep ANCOR members informed of any new developments and strongly encourage you to use the coming weeks to educate your Members of Congress on the importance of our programs. Please enjoy the respite from the Graham-Cassidy bill defeat, but stay alert on changes to Medicaid.
October 2, 2017 — Department of Health and Human Services (HHS) Secretary Tom Price resigned from office after the President expressed dissatisfaction at the Secretary’s use of charter and military transport, which cost taxpayers $1 million in expenses. To learn about who will temporarily run the Department pending a new nomination, what happens to ACA policy next and other key questions, click here.
ANCOR will keep its members informed over the nomination process for HHS as news develops on that topic.
September 25, 2017 — Following discussions with lead policymakers of automakers like General Motors and sharing ANCOR’s policy positions on expanding transportation options, ANCOR gladly accepted an invitation to join the Coalition for Future Mobility, a DC-based coalition that promotes federal support and exploration of self-driving vehicles. In addition to a diverse group of auto industry and policy partners, ANCOR joins the American Council for the Blind and National Federation of the Blind as an additional voice on what opportunities in transportation technology can mean for access for people with disabilities.
To learn more: http://coalitionforfuturemobility.com/
September 22, 2017 — Last week as part of its policy Leadership Summit, ANCOR honored four U.S. Senators with its Congressional Leadership Award for excellence in supporting disability issues.
Senator Collins (R-ME), Senator Murkowski (R-AK), Senator McCain (R-AZ) and Senator Casey (D-PA) were selected for their strong protection of the Medicaid program during the health care debates this past summer. Read the full release here.