Disability Action Center NW, Inc.

The Long Wait for the Budget Resolution

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Reverse Robin Hood Bill Passes in House by Two Votes

Bill Cuts Programs for Those Most in Need Family Opportunity Act and Money Follows the Person Survive

In his January 31st State of the Union address, President Bush outlined his priorities for the coming year. He stated, "Keeping America competitive requires affordable health care. Our government has a responsibility to help provide health care for the poor and the elderly, and we are meeting that responsibility." Although he did not directly mention the disability community, many in the disability community fall into "the poor" or "the elderly" category. While it is not always certain how well the government is meeting that responsibility, we have not given up hope yet! President Bush went on to say, "Keeping America competitive requires us to be good stewards of tax dollars. Every year of my presidency, we have reduced the growth of non-security discretionary spending and last year you passed bills that cut this spending." That statement could not have been more accurate. We feel the pain.

A week after his address, the President sent Congress his Fiscal Year 2007 Budget Request. He promised in his State of the Union address, "This year, my budget will cut it [non- security discretionary spending] again, and reduce or eliminate more than 140 programs that are performing poorly or not fulfilling essential priorities." After a brief analysis of the 2007 budget request, it looks like another year of battling for programs to help our government meet its responsibility for "the poor and the elderly" not to mention people with disabilities. Before we begin this new challenge, let's look back at what happened regarding the Budget Deficit Act of 2005.

Advocates from across the nation came together to join forces in fighting against cuts to Medicaid, Medicare, Temporary Assistance to Needy Families (TANF), student loans, and other reductions that target people who are poor, disabled or elderly, and those trying to get an education. Those coalitions and organizations and grassroots members who sought to educate legislators about the repercussions of these deficit reduction measures worked tirelessly and fought a good fight to lose by only three votes in all of Congress. The Senate voted on the bill before leaving for the December recess and came up with a 50-50 tie, which Vice-President Richard Cheney broke with his vote for approval of the conference report with a few minor changes that sent it back to the House for a final vote. The final vote was along party lines with 13 Republicans joining all the Democrats to oppose the legislation -- but the final vote was 216 to 214 for approval. One could say that this bill became law as a result of three votes in Congress.

To be fair, there are at least two positive provisions in the legislation. The Money Follows the Person Demonstration Act was funded and the Family Opportunity Act was included in the legislation. Money ollows the Person allows for states to receive grants to increase the use of home and community-based services for individuals with disabilities, rather than institutional long-term care services. The Family Opportunity Act expands Medicaid options for states by allowing them to offer Medicaid coverage to children with significant disabilities living in middle income families through a Medicaid buy-in program, a demonstration program for providing alternatives to psychiatric residential treatment for children, restoration of immediate Medicaid coverage for children found eligible for Supplemental Security Insurance (SSI) under the definition of presumptive eligibility and funding for Family to Family Health Information Centers.

Here Is How It Breaks Out:

Higher co-payments and premiums that can lead to necessary services being denied and effectively punishing people with disabilities who have extensive health and long-term service needs. This includes no limits whatsoever on premiums and co-payments that most individuals below the poverty level can be charged.
Reduced benefits. The Congressional Budget Office (CBO) estimates that 1.6 million people would see their benefits reduced in 2015 alone. Most of the reductions in benefits would be for services like dental care, vision, mental health and certain therapies.
A bifurcated health system for children under age 19 that wraps EPSDT services (early & period screening, diagnosis & treatment) around benchmark plans and raises serious access and quality assurance issues.
Exacerbation of the institutional bias through its application of premiums on Medicaid beneficiaries, because people with disabilities living in the community can be charged substantial premiums while those in situations are exempt.
Changes to asset transfer rules for people who need nursing home care.
Citizenship documentation requirements for those applying for Medicaid.
Enacting changes to home and community-based services that promote HCBS services, but gives states the option of putting a capped program within a Medicaid State Plan (to advocates this appears to codify "waiting lists").
Providing states the option of implementing Cash and Counseling Programs, but only to those who live in their own or in their family's homes not with roommates or in group homes.
Delaying certain Supplemental Security Income payments for up to a year for many low income individuals with disabilities who are found eligible for SSI.
Cutting foster care funding, making it more difficult for states to provide federally-funded foster care payments to certain relatives who are raising children because the children's parents are unable or unfit to do so.
TANF reauthorization that toughens work participation rates, subjects state maintenance of effort dollars to federal TANF work requirements, and develops a standardized set of approved work activities without ensuring states have the flexibility to meet the needs of families that include a person with a disability.
A reduction in American Indian/Alaskan Native health services.
And last but not least, almost one-third of the spending cuts are to student loans. The bill imposes higher fees on students, increases the interest rate on parent loans, eliminates all mandatory spending to administer the country's higher education programs, and cuts some subsidies to lenders.

So, it's time to again put on our battle gear. Do the best we can with the upcoming regulations on what is now law. ADVOCATE with our community on what is being requested in the FY 07 budget, and remember -- this is a mid-term election year! GET OUT THE VOTE!!!