We are pleased to invite you to an event
with Health and Human Services Secretary Kathleen Sebelius for an important
announcement on the status of children's health coverage and moving forward on
the Connecting Kids to Coverage Challenge.
Enroll 5 million uninsured children eligible for Medicaid and CHIP in the next
five years!
Friday, September 3, 2010
9:00 a.m. to 10:00 a.m.
The Great Hall
Department of Health and Human Services
Hubert H. Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C.
To RSVP:
Please email externalaffairs@hhs.gov by noon, Thursday, September 2.
If you have any questions please call Amanda Aguirre, 202-260-6179
Please feel free to share this information with others. All are welcome,
however, you must RSVP to enter to the building.
The event will provide a forum for the release of new data from the Urban
Institute, to be published in Health Affairs on Friday morning. The report
provides state-level information on children's participation in Medicaid and the
Children's Health Insurance Program (CHIP) and helps define the direction for
future work. The Secretary also will recognize leading national organizations
that have stepped up to the Connecting Kids to Coverage Challenge and will
highlight several important contributions to outreach and enrollment efforts.
[Ed. Note] I will try to get the
minutes and post them here.
And Even More
August 27, 2010
NASMD pushes back against defecting
Medicaid directors:
The head of the human services group overseeing the National Association of
State Medicaid Directors (NASMD) says that defecting Medicaid chiefs — who
recently formed the independent National Association of Medicaid Directors — are
risking the advantages of their affiliation with state agencies running child
welfare, nutrition and disability programs that share Medicaid's goals.
"There are so many places where medical and human services intersect," Cari
DeSantis, interim executive director of the American Public Human Services
Association, was quoted as saying. "We can't lose sight of that."
Apparently There Is More
To The Story
August 26, 2010
Human services group says defection of Medicaid directors inconsequential
The recent decision of some Medicaid
chiefs to leave the National Association of State Medicaid Directors (NASMD) and
form their own lobbying group will have "no immediate effect" on NASMD's
operations, according to the head of the human services association overseeing
the group.
"We'll continue to do the work that we
do," Cari DeSantis, interim executive director of the American Public Human
Services Association (APHSA), said in a phone interview Wednesday. NASMD's
annual conference in November, for instance, is still on, she said. "Not really
anything has changed."
Still, DeSantis conceded that APHSA
officials are scurrying to evaluate the long-term significance of the breakup,
as they install new leaders and reach out to states with the message that it's
still business as usual in Washington.
"I don't know what's real and what's not
real," DeSantis said of the new group.
Since 1979, NASMD, an APHSA affiliate,
has represented the nation's Medicaid directors in Washington. But NASMD's
12-member executive committee voted this month to split from APHSA and create a
separate organization, the National Association of Medicaid Directors (NAMD).
Led by Carol Steckel, head of Alabama's
Medicaid program, the new group says its independence from APHSA will be an
asset as states move to implement the many changes contained in the Democrats'
new healthcare reform law.
"Health care reform moves us, in
hyper-speed, into a new and challenging world that will require each of us and
our national organization to be more flexible," Steckel wrote last Thursday to
colleagues seeking support for NAMD.
But DeSantis says NAMD's flexibility
will come at the price of losing access to the resources of the other affiliates
under APHSA's umbrella. State child-welfare programs, disability services and
food-stamp initiatives all intermingle with Medicaid toward the common goal of
keeping vulnerable populations healthy, she said.
"There's a lot to be said for the
interconnectedness of health and human services," DeSantis said. "There are so
many places where medical and human services intersect. We can't lose sight of
that."
Steckel did not respond to requests for
comment this week.
Some Medicaid directors said the push
for an independent Medicaid group has lasted for more than a decade, fueled (at
least in part) by a perception that NASMD's resources are used to fund some of
the other APHSA affiliates — something DeSantis said is "flat-out not true."
It's yet unclear how the independent
NAMD group has been received by states not represented by members of NASMD's
executive committee, who voted unanimously to defect.
APHSA officials are quick to note that
many state Medicaid directors are not their own bosses, but instead work within
state human services departments. With that in mind, APHSA says, it will be
difficult for those Medicaid programs to join the new group, even if their
leaders prefer the stand-alone model.
Amid the shakeup, NASMD has fired its
director, Ann Kohler, and replaced her with Rick Fenton, a 31-year veteran of
the Centers for Medicare and Medicaid Services.
It's not the only shake-up at APHSA this
month. In an expected move, the group announced Thursday that DeSantis, who's
been interim executive director since February, will step down late next month.
Tracy L. Wareing, now a senior adviser
to Department of Homeland Security Secretary Janet Napolitano, will replace her.
Some State Medicaid
Directors Leave
Longtime Association,
Form New Group
August 24, 2010
A group of state Medicaid directors has
decided to split from the association that represents them in Washington, saying
Medicaid officials need an organization dedicated solely to the program,
particularly as they implement the health reform law.
The National Association of State
Medicaid Directors has represented state Medicaid directors as an affiliate of
the American Public Human Services Association since 1979, but the NASMD
executive committee voted recently to form a separate group.
“We all felt that there was a need for
an independent organization focused solely on Medicaid,” Carol Steckel, who
heads the Alabama Medicaid program and chaired the NASMD executive committee,
told BNA Aug. 24. Steckel, who will serve as president of
the new group known as the National Association of Medicaid Directors, said that
with the Medicaid program decoupled from welfare programs, and the considerable
responsibilities Medicaid programs will undertake as part of the health reform
law, it was time for a change.
Collaboration with other human services
organizations will remain critical for Medicaid, but the directors will have an
easier time implementing health reform if they have an independent group to
represent them, she said.
Steckel said the newly formed NAMD is
“up and running” with a board of directors in place and now is working on
gathering members. She declined to name which states already have decided to
join. “We will be a voice for Medicaid
directors but that will be an individual choice each director will have to
make,” she said. The organization would not preclude a state from participating
in NASMD as well as the new group, if it chooses to do so. Stan Rosenstein, a former California
Medicaid director and former vice chair of the NASMD executive committee, said
the decision to form NAMD is a logical one. “I think it's really part of the
evolution of Medicaid,” Rosenstein, who is now a principal adviser with the
research and consulting firm Health Management Associates, told BNA Aug. 24.
Rosenstein said forming a separate
organization has been under discussion for some time and that he feels passage
of the Patient Protection and Affordable Care Act (Pub. L. No. 111-148)—under
which Medicaid is expected to gain 16 million new beneficiaries and will take on
new responsibilities such as coordinating with state insurance
commissioners—made it clear that the directors should make their move.
“It's really time to be on their own,”
he said. Rosenstein said he expects most states will choose to join NAMD and
that there will not be distinctions among who chooses to do so based on
demographics. In addition, he said the split will not change the relationship
between the Medicaid directors and the federal government.
While states may end up deciding between
NAMD and NASMD, Rosenstein said he expects states will continue to participate
in the divisions of APHSA that deal with other areas of health and human
services.
APHSA Aug. 24 announced that Rick Fenton
has been named acting director of the group's Health Services Division, which
includes NASMD. Fenton, who previously served as deputy director of the Health
Services Division, replaces Ann Kohler, a former New Jersey Medicaid director.
Well Worth Reading
August 24, 2010
Each year the Children's Defense Fund
publishes a report on a wide variety of children's issues, including key facts
and figures and sections on education and health. I highly recommend you
go to
their site and download copies of the specific reports of interest to you.
Unbelievable!!!
August 22, 2010
Advocate earned $1.6 million while
school budgets were slashed!
At a time when California school board
members were agonizing over laying off employees, slashing programs and imposing
furloughs, the man who was the boards' public face earned $1.61 million over
four years.
Scott Plotkin's base salary rose 52
percent from 2006 to 2009, plus he received annual bonuses -- $175,000 in 2008
alone -- according to information released Thursday by his employer, the
California School Boards Association.
Plotkin, 56, retired effective Sept. 1,
after admitting that he publicly lied about his pay and credit card use. In
July, Sacramento television station KCRA reported his salary and revealed that
Plotkin used his CSBA credit card to take out $11,000 in cash advances at
casinos. Plotkin claimed the CSBA board knew about the advances; he later
admitted that was not true. Plotkin, who has apologized for his "misstatements,"
could not be reached for comment.
CSBA, a nonprofit organization with a
$16 million annual budget, including $5.9 million in member dues paid by nearly
1,000 school boards, initially refused to release financial information. Under
pressure, its 32-member board voted Tuesday to post on its website financial
statements as well as compensation for Plotkin and seven other executives. It
also apologized for lack of oversight. It appears that the board did not
realize how much Plotkin was making.
"There was piecemeal information," said
Judy Hannemann of Los Altos, who represented Santa
Clara County school board members on the
CSBA from 1994 to 2008. Two years ago, she said, when the state budget crisis
hit schools hard, Plotkin told his board that he was taking a 4 percent pay cut.
That turned out to be false, but board
members didn't realize it, Hannemann said. Instead, she said, the CSBA board
relied on its four-member executive committee to provide information about CSBA
staff compensation. And it valued Plotkin, who was highly visible statewide as
he explained complicated education policy and advocated forcefully for increased
funding for schools."Our goal was to reward him for the services he was giving
us," said Hannemann, who is also a trustee for the Mountain View-Los Altos High
School District. "He's really well respected throughout the nation."
Plotkin was the chief spokesman when the
CSBA announced in May that it was suing the state of California over inadequate
funding for schools. California's funding system violates the state
constitution's provision of common schools, the suit alleges. "We're going to
try get people engaged in the right kind of conversation about what it takes to
support schools in California," Plotkin said about the suit.
But Plotkin's behavior and salary have
made school trustees' work a lot harder, some said.
"I am outraged," said Dana Tom,
president of the Santa Clara County School Boards Association. "The biggest
arrows in our quiver of support for public education are integrity and trust.
You can break trust in an instant, but it takes time to rebuild it. "The Plotkin
scandal "is a huge distraction from the real issues we face in education," said
Tom, who is also a trustee of the Palo Alto Unified School District.
County delegates to the CSBA are meeting
next week to discuss the uproar."You have to look forward," said Jo Lucey, who
called the meeting and is the current representative to the CSBA for Santa Clara
County school board members. She said she, too, didn't know Plotkin's total
compensation. "What we need to do is put in place better checks and balances and
better processes."Despite the revelations, she said, she's confident that
members value CSBA's services, including training in leadership, policy,
education and a host of other topics.
As an employee of CSBA and a former
employee of the California state Senate and California State University, Plotkin
is eligible for a pension from the California Public Employees' Retirement
System. A CSBA spokeswoman, Brittany McKannay, said the value of the pension
hadn't been calculated yet.
CSBA chief's salary
Gross salary, bonus, incentive and
annual allowances that the California School Boards Association said it paid to
Executive Director Scott Plotkin:
By Jon Shure,
Deputy Director of the State Fiscal Project.
No
state has been hurt more by the recession
than Michigan, where unemployment tops 13
percent and home values have plummeted in
many areas. So a few days ago, when many
communities across the state voted on ballot
questions to raise money for local services,
the result could only be a disaster for
supporters of higher taxes, right?
Wrong.
Voters approved 86 percent of the 623 ballot
proposals calling for higher taxes or fees,
according to an
analysis by the Center for Michigan, a
respected non-partisan policy institute.
They
supported 96 percent of requests to renew
expiring taxes or reverse previous tax cuts,
according to the report. Even proposals for
new tax increases passed at a 69 percent
rate.
What’s going on? Well, once again the voters
showed that they get it. While “tax
revolts” often get the headlines, voters
know that the services they depend on — like
roads, schools, libraries, and fire
protection — cost money. And they’re
prepared to pay to maintain those services
as part of a
balanced approach to addressing the
worst recession of our times.
In
contrast, closing budget shortfalls entirely
by cutting services
hurts people in need, threatens the
economic recovery by reducing overall
demand, and fails to make needed investments
in the future.
Still Time to Register
for the NAME Conference
August 10, 2010
Have you registered for the NAME Annual
Conference yet? It’s not too late! If you are new to Medicaid in Education,
consider attending the NAME ACADEMY Tuesday afternoon of September 21st. This
Pre-Conference feature is broad in scope, with just enough details, yet small
enough to allow great discussions. This session is NOT included in the general
Conference registration fee, so just sign up, pay the $75 before August 31st and
arrive early! See the
2010 Pre-Conference Sessions
page for more information.
Getting Your Kid Covered and in the Game
Posted August 12,
2010
By Cindy Mann, Deputy
Administrator and Director of the Center for Medicaid, CHIP, and Survey &
Certification at the Centers for Medicare and Medicaid Services
Here is my confession: when the
World Cup was televised last month, I didn’t view a single game. When people
talk about “March Madness,” I think they’re talking about the quirkiness of the
weather. I love riding my bike – but not watching the Tour de France.
Even though I’m not much of a sports fan, I knew how important it was to go and
cheer on my daughters when they played field hockey in high school. Physical
activity is so important for good health – and organized sports are the best way
to get most kids moving. When it comes to participating in school and community
sports, nothing should stand in a child’s way – especially the lack of
affordable health insurance.
But without health insurance, it’s hard for kids to get the physical exams they
need to be able to play. For other families, the fear of medical bills that
could result from a sports injury leave them reluctant to let their children
participate.
Health care is getting better. So is HealthCare.gov. Where you see  add your
comments to help us improve.
You may know your state’s health insurance program for kids by another name,
such as Healthy Families, KidCare, or Child Health Plus, but they all provide
the health benefits every child needs. The plans may be free or available at a
very modest cost. Generally, children up to age 19 in families of four with
income up to $45,000 a year can qualify. In many states the income limit is
higher, so more children in working families are eligible. Even if your child
has not been able to get coverage in the past, it’s worth trying again. Usually
you can mail in an application and in many states you can apply on line.
It’s easy to find out more about the children’s health coverage options in your
state and learn about how to enroll your child. We also have flyers and other
materials on our website, InsureKidsNow, designed just for coaches, school
nurses and anyone else who works with kids and can play a role in helping
families with eligible kids find coverage.
As back-to-school time approaches, families are thinking about making sure their
children have every opportunity to learn. Now is also the time to make sure that
kids have the coverage they need to be healthy – the first step to a successful
school year.
Health coverage also will help your kids get in the game, whether their passion
is soccer or basketball -- or jumping rope on the playground. They’ll get
exercise and have fun – and you’ll know they’re protected on and off the field
for long after the sports season is over. Sign them up and let the games begin!
DOE Response to LEAnet Letter Re:
Parental Consent
August 13, 2010
Just a little editorial comment, from
one who has worked at the local, state, regional and federal government levels:
The second to the last paragraph in the response is the most important. By
acknowledging there is an issue is a tremendously significant statement
and to see in the letter that DOE is continuing to research the issue may be
bureaucratic shorthand for something more promising.
Aetna announced today that it would stop
selling child-only individual health insurance policies after October 1, 2010. A
child-only policy is one sold to [for] a child who is under the age of 19. Many
parents who cannot afford to insure the whole family will buy a policy just to
protect the health of their children.
The announcement affects only new business sales. Aetna policy holders who
already own a child-only plan will not be impacted by new rule. Current policies
will continue as written and these policies will also be renewable. Child-only
polices had been written under the Aetna Advantage Plans for Individuals,
Families and the Self Employed.
Is change in response to new federal law?
Under the Affordable Care Act, insurers who sold health insurance policies would
be prohibited from excluding children with pre-existing conditions from coverage
beginning in 2010.
Just after the signing of the new federal law, insurance company lawyers
attempted to argue that children with pre-existing conditions would have to wait
until 2014 for guaranteed issue coverage, just as adults do.
The Obama administration through Health and Human Services Secretary Kathleen
Sebelius immediately announced that it would publish regulations making the
change effective September 1, 2010.
The insurance industry grudgingly accepted the direction. Karen Ignagni, CEO of
America’s Health Insurance Plans (AHIP), responded that the insurance industry
would “fully comply” with the principles set forth in the Secretary’s letter.
AHIP is a trade organization and political advocacy group that represents over
1300 insurance carriers.
Are insurance companies finding new ways to avoid the requirements of the
federal law?
Aetna admits the reason for stopping the sale of child-only policies is to allow
the company to handle the upcoming changes which resulted from health care
reform. Specifically Aetna notes that the requirement to insure children under
the age of 19 on a guaranteed issue basis with no guidelines as to coverage
requirements has the potential to increase the cost of these policies and make
them unaffordable.
What remaining options are available for child-only policies?
Aetna says that if an application for a child-only policy is submitted for an
effective date of October 1, 2010 or later, the underwriters will suggest the
following options for covering the child:
• Add the child as a dependent to a parent's plan,
• Apply to your state’s CHIP plan (if eligible), or
• Check with federal government for alternative options at www.healthcare.gov
Currently the federal website has no options to suggest for child-only coverage.
Aetna’s announcement has indicated that this policy will become effective on
October 1, 2010 in the following states: AK, AR, AZ, CA, CO, DC, DE, FL, GA, IL,
IN, KS, KY, LA, MI, MO, MS, NC, NE, NV, PA, SC, TN, TX, VA, WV, and WY. A later
announcement will establish the effective date for the change in CT, MD, OH, and
OK.
CMS - Office of External Affairs
Get Covered. Get in the Game.
New initiative promotes enrollment of
eligible children in
Medicaid and CHIP through school and
community sports activities
Wednesday, August 4, 2010
WASHINGTON, DC - The U.S. Department of
Health and Human Services (HHS) is launching the Get Covered. Get in the Game.
initiative in seven pilot states across the country – Colorado, Florida,
Maryland, New York, Oregon, Ohio and Wisconsin. The initiative is part of the
Connecting Kids to Coverage effort, led by HHS Secretary Kathleen Sebelius,
which calls on government and business leaders, health and human services
providers, schools, the faith community, and those working with children in any
setting to find and enroll roughly five million uninsured children in the U.S.
who are currently eligible for Medicaid and the Children’s Health Insurance
Program (CHIP).
“Even as we move forward with health
insurance reform for all Americans, we must not lose our momentum to insure kids
now,” said Secretary Sebelius.
Get Covered. Get in the Game. brings
together coaches, schools, and communities to educate families with children who
are eligible for Medicaid or CHIP about the immediate availability of children’s
health coverage programs. The National Council of Youth Sports estimates 44
million boys and girls participate in organized youth sports. Uninsured kids
often miss out because they cannot afford the necessary physical often required
to participate in youth sports or because their families are concerned they
would be unable to pay for treatment if their kids get hurt.
“Healthy kids do better in school and in
life because they are able to participate fully in activities that develop their
bodies and their minds,” Secretary Sebelius said. “Kids should not have to miss
out on their favorite sports and other activities that get them moving because
they lack health insurance coverage. With Medicaid and CHIP, eligible children
can be covered both on and off the field.”
Get Covered. Get in the Game. will
provide coaches with information about CHIP and Medicaid and how families can
get their eligible children enrolled. Coaches and others in the school community
can serve as a resource to families to help ensure that children are linked to
vital health benefits. CMS will support events launching this initiative,
outreach to news outlets across the pilot states, coaches’ trainings, and the
placement of promotional materials at select youth sports events to help direct
families to enrollment assistance.
For more information about enrolling in
children’s health insurance programs, please call 1-877-KIDS-NOW
(1-877-543-7669) or visit www.InsureKidsNow.gov. Educational materials for
coaches and parents are available on this site.
Arizona Drops the CHIP
Program, Stands to Lose Millions in Federal Funding
March 24, 2010
A controversial decision
by Arizona lawmakers to eliminate a health insurance program for poor children
puts it at risk of losing billions of dollars in federal Medicaid funding under
the historic health care bill approved by Congress.
Arizona last week became the first state to eliminate its Children's Health
Insurance Program, removing an estimated 38,000 kids from the rolls starting in
June in a budget-cutting move by Gov. Jan Brewer and the Republican-led
Legislature.
State officials said Monday the move could have devastating consequences because
of the health insurance plan just passed by Congress.
Rep. Kyrsten Sinema, D-Phoenix, told Brewer and House Speaker Kirk Adams in
separate letters that eliminating the state's KidsCare program on June 15 would
violate a "maintenance of effort" requirement of the Senate health care overhaul
bill approved by Congress.
The state's Medicaid program, the
Arizona Health Care Cost Containment System, now provides coverage to
approximately 1.3 million Arizonans.
Monica Coury, an AHCCCS assistant director, confirmed that the overhaul bill
requires Arizona to keep its current eligibility intact and hinges all of the
state's federal funding for Medicaid on it.
"That's what the language says," Coury said.
Arizona expects to receive nearly $7 billion in the current fiscal year,
according to the legislative budget office.
"I cannot believe that this Republican legislature would be willing to forfeit
every federal Medicaid dollar that Arizona receives, once they understand the
implications of doing so," said Sinema, the House Democrats' assistant leader
and their point person on health-care funding. "Arizona cannot afford to give up
that care."
Earlier Monday, Brewer spokesman Paul Senseman said state officials were trying
to determine the implications and requirements of the federal health care
legislation, but said there was a potential for a "gigantic hole" in the state
budget.
However, federal officials "haven't made any threats to us yet" to cut off
funding, Senseman said.
Adams, R-Mesa, said legislative analysts were reviewing the federal health
overhaul legislation's requirements and that he did not immediately know whether
Sinema was correct.
Sinema released copies of e-mails in which federal officials said over the
weekend that the health care overhaul legislation requires a state to maintain
current programs, including a CHIP, to remain eligible for Medicaid funding.
Sinema and other House Democrats want Adams, R-Mesa, to permit late legislation
to expand the state sales tax to raise the $22 million needed to keep
KidsCare. The
Democrats suggested applying the tax to retail sales of extended warrants on
products such as televisions.
Apart from the KidsCare elimination, a separate funding cut included in the
state budget signed by Brewer would drop 310,000 people from AHCCCS coverage in
January unless new federal funding is provided.
Brewer had urged the state's congressional delegation to vote against the
overhaul, complaining that the Senate bill would inflate costs to the already
financially struggling state.
However, a last-minute change provided Arizona and 11 other states with
additional funding under the federal legislation because their Medicaid programs
were more generous. U.S. Rep. Harry Mitchell, D-Ariz., said the increased
funding "was a critical factor" in his decision to vote for the bill.
According to a chart released by Sinema, the new federal funding for three years
starting in 2014 will pay 100 percent of Arizona's costs for people newly
eligible for coverage, with the reimbursement level dropping to 90 percent by
2010.
The state now receives reimbursements ranging from 66 percent to 75 percent.
How Health Care Reform Reduces the Deficit in 5 Not-So-Easy Steps
Thousands of teachers face layoffs as recession meets falling enrollments
Thursday, March. 18, 2010
At the center of the
country’s school funding crisis are little boys and girls like Kyle Wolfe, a
3-year-old pupil in Rising Stars, a pre-kindergarten program for at-risk
children in communities near Rockford, Ill.
“I can’t even begin to describe the way Kyle has grown since starting this
program,” said his mother, Carolyn.
Last week, the Harlem School District Board of Education, which serves the
communities of Loves Park, Machesney Park and southern Roscoe, voted to
eliminate Rising Stars because the state of Illinois hasn’t made good on the
grants that support it. The vote means the nearly 400 youngsters the program
serves “will be entering kindergarten delayed academically and socially,” said
Lynn Wade, a pre-K teacher at the Donald C. Parker Early Education Center in
Machesney Park.
No one disputes that Rising Stars is “an excellent program,” said Julie M.
Morris, the school district’s superintendent. The decision to kill it “has
nothing to do with how the program is run or what it provides to our students.”
It’s just money.
Thousands of administrators and school board members across the country are
making similar agoniziang choices. While the recession has put a squeeze on all
types of government programs, none has felt its impact more than education — the
largest item in most states’ budgets.
Now, many states have nearly exhausted their windfalls from the federal
economic stimulus plan, and with falling housing values shrinking property tax
revenue — the largest source of public school funding — the question for state
and local officials planning budgets for the next school year is: Will it be bad
— or horribly bad?
For schools, historic decisions
The retrenchment is coming as the Obama administration seeks to overhaul
education law in a way that makes schools compete for federal grants. But
critics say the focus should be on expanding funding for all schools, not
imposing even higher standards while redistributing less money.
“Resources must be adequate and equalized across schools,” Dennis Van Roekel,
president of the National Education Association, said last week in congressional
testimony on the plan.
Citing research by the NEA, the nation’s largest teachers union, he said that
“almost no states are currently funding their educational systems adequately,
and most states are around 25 percent short of funding their systems at a level
adequate.”
Cuts that have been announced this year are staggering:
The Kansas City, Mo., School District is closing nearly half its 61
schools, with almost 300 teachers among those losing their jobs once 29 campuses
go dark.
The Montgomery, Ala., Public School Board voted last week to lay off more than
600 employees, including 415 teachers, in what it said was just the first phase
of staff reductions.
In the northwest suburbs of Chicago, the Illinois 46th District school board
this week approved a proposal to lay off more than 1,000 employees — about 25
percent of the district’s staff — to help make up a projected deficit of $44
million. More than 700 teachers would lose their jobs, including all first-,
second- and third-year instructors.
Statewide, Illinois schools face budget cuts as high as 17 percent to make up a
$1.3 billion education deficit, Gov. Pat Quinn warned last week.
In Atlanta, Superintendent Beverly L. Hall said this week that after years of
cutbacks, her district’s 2010-11 budget will be almost 11 percent below its
level of seven years ago.
Calling the impact a “category 5” crisis, Georgia’s state superintendent, Kathy
Cox, said, “It’s going to be very tough next year. The stimulus came in and
helped, but the cliff is coming."
Tens of thousands of California layoffs possible
As stark as those figures are, they pale in comparison to the numbers lawmakers
are wrestling with in California.
California school districts issued preliminary layoff notices Monday to about
22,000 teachers and administrators, nearly 7 percent of the professional
workforce; 10,000 so-called classified workers — bus drivers, maintenance
workers and cafeteria staff — could also get the ax, state Superintendent Jack
O’Donnell said.
Nearly 900 teachers and administrators would lose their jobs in the San
Francisco Unified School District, which must cut $113 million over the next two
years.
“You’re inadequately funding students,” said Superintendent Carlos Garcia, whose
district is considering suing the state to force it to fully fund schools.
“If you don’t act now, 10 years from now where are we going to be?” Garcia said.
“We need to take control ourselves.”
How did we get here?
Administrators had already been struggling to transform schools as population
shifts to the suburbs left big-city districts with shrinking enrollments and
excess facilities and suburban districts with ballooning enrollments crammed
into inadequate facilities.
The recession, which started in late 2007, accelerated that transformation and
brought it to a crisis. Faced with rapidly falling budgets, hundreds of urban
districts are racing to close schools and consolidate teaching staffs: Detroit,
where enrollment has fallen by 49 percent since 2002, announced Wednesday that
it plans to close 44 underused campuses and a support facility; Cleveland, where
enrollment has fallen to its lowest level since the 1890s, plans to close 16
schools, or more than 10 percent of its facilities; Pittsburgh, where enrollment
has fallen by 35 percent since 1997, has closed 18 schools and put them up for
sale.
“This is really impacting our large metro-area systems, and they’re making some
very tough decisions about programs,” said Cox, the Georgia superintendent.
Those decisions aren’t abstract.
Federal education figures show that employee salaries make up about 80 percent
of the typical school district’s budget. That means that “if you have to reduce
your budget substantially the only way to do that is to reduce your teaching
staff,” said Eric Churchwell, superintendent of schools in Palmyra, Mo.
Teacher layoffs mean bigger classes, said Churchwell, who projected that the
student-teacher ratio at Palmyra High School could rise by 50 percent — from
20:1 to 30:1 — because of layoffs forced by cuts in the state education budget.
“The analogy I would use is we’re dealing with a tsunami rolling through our
school divisions right now,” said David Stuckwisch, superintendent in
Portsmouth, Va., which has shed nearly 350 jobs in the last few years and
expects to see 90 more disappear in the next school year.
Joel Klein, chancellor of the New York City public schools, said the city had
closed about 90 schools during this decade and faces the prospect of laying off
as many as 8,500 teachers — or nearly 11 percent of its total — depending on how
the state education budget turns out.
When that happens, Klein said, it’s students who pay the price.
“A lot of people complain about who got us into the financial mess we’re in,” he
said. “I promise you this: The kids in New York City didn’t, and they shouldn’t
bear the brunt of it.”
Congressional Budget Office says
tne current version of the Health Care Reform Legislation will reduce the
federal deficit by $138 billion over its first 10 years
March 18, 2010
For Summary of the Reconciliation
Provisions, click
here.
Program
integrity, error prevention and fraud-fighting will move up the CMS food chain
under a proposed reorganization of the agency that is expected to be finalized
in mid-April.
CMS has proposed a new Center for Program Integrity that would report directly
to the CMS administrator, according to an internal CMS e-mail. The center would
be run by a new deputy administrator, and CMS has selected Peter Budetti, M.D.,
J.D., to serve in this role. Budetti is a former congressional counsel,
university professor and chair of Taxpayers Against Fraud, the Washington, D.C.,
nonprofit agency that supports False Claims Act cases.
If HHS Sec. Kathleen Sebelius approves the reorganization, as expected, CMS will
have a new principal deputy administrator. The person designated for this job is
Marilyn Tavenner, former Virginia secretary of Health and Human Services. There
will also be a new Office of External Affairs and Beneficiary Services and four
new centers, each led by deputy administrators:
(1) The Center for Medicare, which will report directly to the CMS
administrator, combines Medicare fee-for-service, managed care, and the
prescription drug benefit. Deputy Administrator Jonathan Blum and two deputy
center directors will run this center. “Existing groups/staffs of the current
Center for Medicare Management and Center for Drug and Health Plan Choice will
be realigned intact under the new Center,” the e-mail states.
(2) The Center for Program Integrity will absorb some Medicare and all of the
Medicaid program integrity operations. Kim Brandt, the longtime director of
program integrity, will become part of the Center for Program Integrity. She is
in charge of the zone program integrity contractors (ZPICs), which focus on
fraud and abuse and enrollment. The Medicaid Integrity Group will be located in
the Center for Program Integrity. However, the Provider Compliance Group will
not move over to the new Center for Program Integrity. It will remain under the
Center for Financial Management, which will become part of the new Center for
Medicare. George Mills will continue to be the director of the Provider
Compliance Group, which oversees recovery audit contractors (RACs), medical
review, and comprehensive error rate testing (CERT). The emphasis of the
Provider Compliance Group is on payment-error prevention and detection and
error-rate calculation.
(3) The Center for Medicaid, CHIP and
Survey & Certification is the new name for the Center for Medicaid and State
Operations. The center will report
directly to the administrator. Deputy Administrator Cindy Mann and two deputy
center directors will operate the center. Existing groups/staff will remain in
the renamed center, except for the Medicaid Integrity Group.
(4) The Center for Strategic Planning realigns the Office of Research,
Development, and Information and the Office of Policy. This center will report
directly to the administrator and be operated by the deputy administrator.
CMS says Budetti “is considered one of the leading experts in the United States
on health care fraud.” In addition to running health administration and policy
departments at three leading universities since 1990, he has been the Visiting
Professor for Health Care Fraud at the National Association of Insurance
Commissioners since last year. He also was a staff member for the Senate Finance
Committee and counsel to the U.S. House Subcommittee on Health and the
Environment under Chairman Henry Waxman (D-Calif.).
The fact that program integrity is now its own center, with direct-line
reporting to the CMS administrator, is seen as significant. “Program integrity
got bumped up in importance,” says one observer, who declined to be identified.
From the
Feb. 22, 2010, issue of REPORT ON MEDICARE COMPLIANCE
Summary of the
President's New Health Care Proposal
Last
year's federal stimulus package provided $87 billion in fiscal relief to states,
helping them to prevent cuts to social service programs. This relief allowed
states to continue to serve children, youth and families at a time of increased
need and falling state revenues.
This assistance is scheduled to expire on December 31, 2010, in the middle of
most states' fiscal years. Unfortunately, state revenues are not projected to
increase in the coming fiscal year; in fact, states currently face shortfalls
totaling $140 billion in fiscal year 2011. This means that without additional
fiscal relief, states will have to institute massive new budget cuts and tax
increases at the start of the new fiscal year on July 1, when unemployment is
expected to remain at or near double-digit levels and the economy will likely
still be fragile.
Already Governors around the country are proposing severe cuts to programs
benefitting children and families, for example:
Arizona's governor is proposing deep cuts to a range of programs and
services. If enacted, her budget would: eliminate the state's children's
health insurance program (KidsCare), which covers 47,000 children; make deep
cuts to support for early learning by eliminating preschool for 4,328
children and eliminating state support for full-day kindergarten; and reduce
the number of months that low-income families can receive cash assistance
through the Temporary Assistance for Needy Families (TANF) program,
immediately eliminating assistance for 10,000 poor families, among other
cuts.
Colorado's governor proposes to eliminate a scheduled increase in K-12
funding that would cover enrollment and cost increases and implement an
additional cut of $223 million in school aid. He also proposes delaying
payments to Medicaid providers and cutting payment rates.
New
York's governor is proposing a $1.1 billion cut to state education aid; more
than $400 million in reduced payments to health care providers and about
$100 million in other health-related cuts; $143 million in funding cuts for
four-year public colleges and cuts to a financial aid program serving
students from low- and moderate-income families.
When
he is not busy flying to Argentina or hiking the Appalachian Trail, South
Carolina's governor is proposing capping total enrollment in the state's
children's health insurance program.
The Long-Awaited Lewin
Report Has Been Released to the Public
Ho-Hum
February
10, 2010
Excerpts
from the 109 page report are below. If you are having trouble sleeping,
you can find the whole thing
here.
N.B.
The typical high-end consultant's report is approximately 40% regurgitation of
what the client says and already knows, 40% boilerplate from other similar
reports, and 10% solutions/findings. The latter are also boilerplate,
having been offered as solutions/findings in previous reports.
Legislation [H.R.
4247] introduced to prevent and reduce the use of
physical restraint and
seclusion in schools, and for other purposes
February
9, 2010
Summary:
Preventing Harmful Restraint and Seclusion in Schools Act - Directs the
Secretary of Education (Secretary) to establish minimum standards that: (1)
prohibit elementary and secondary school personnel from managing any student by
using any mechanical or chemical restraint, physical restraint or escort that
restricts breathing, or aversive behavioral intervention that compromises
student health and safety; (2) prohibit such personnel from using physical
restraint or seclusion, unless such measures are required to eliminate an
imminent danger of physical injury to the student or others and certain
precautions are taken; (3) require states and local educational agencies (LEAs)
to ensure that a sufficient number of school personnel receive state-approved
training and certification in first aid and certain safe and effective student
management techniques; (4) prohibit physical restraint or seclusion from being
written into a student's education plan, individual safety plan, behavioral
plan, or individual education program as a planned intervention; and (5) require
schools to establish procedures to notify parents in a timely manner if physical
restraint or seclusion is imposed on their child.
Authorizes the Secretary to award grants to states and, through them,
competitive subgrants to LEAs to: (1) establish, implement, and enforce policies
and procedures to meet such standards; (2) improve their capacity to collect and
analyze data related to physical restraint and seclusion; and (3) implement
school-wide positive behavior supports.
Directs
the Secretary to conduct a national assessment of this Act's effectiveness.
Gives
Protection and Advocacy Systems the authority provided under the Developmental
Disabilities Assistance and Bill of Rights Act of 2000 to investigate, monitor,
and enforce this Act's protections for students.
Directs
the Secretary of Health and Human Services to establish standards for Head Start
agencies that are consistent with the minimum standards for the management of
elementary and secondary school students.
Authorizes the Secretary to allocate funds to the Secretary of Health and Human
Services to assist Head Start agencies in establishing, implementing, and
enforcing policies and procedures to meet such standards.
Senate Passes Historic
Health Insurance Reform Legislation
December 24, 2009
In a rare
Christmas session, the Senate passed the health reform package on a vote far
exceeding the amount needed for passage.
Full
story here.
Vast Majority of
Children Would Be as Well Off or Better Off
Under House Health
Bill than Under Current Law.
Bill Would Make
Substantial Progress for Children Overall
December 22, 2009
by Judith
Solomon, Center on Budget and Policy Priorities
“An examination of how the almost 79 million
children under age 19 would fare under the House-passed health reform bill shows
that the overwhelming majority likely would either see no change or be better
off than under current law, with tens of millions better off.
“Some have criticized the bill out of the belief that its phaseout of the
Children’s Health Insurance Program (CHIP) at the end of 2013 would result in
many millions of children being worse off than they are today. Some children
could indeed be worse off under the House bill. These children would constitute
a small fraction of the number of children who would gain under the bill,
however, and would make up significantly fewer than 5 percent of the children in
the country.”
The Patient Protection
and Affordable Health Care Act
Now Playing at a
Theater Near You
November 18, 2009
Today, Senate Majority Leader Harry Reid released the Senate version of
the health insurance reform bill. The bill was merged from the bills
passed by the Senate Health Committee and the Senate Finance Committee.
Here are some resources you may find useful in following the health care
reform issues, with thanks to Senator Debbie Stabenow [D-MI], a member
of the Senate Finance Committee and the Senate Finance Committee
Subcommittee on Health.
The Patient Protection and Affordable Care Act The merged Senate health care bill, called The
Patient Protection and Affordable Care Act, will ensure that all
Americans have access to quality, affordable health care and will create
the transformation within the health care system necessary to contain
costs.
The Centers for Medicare & Medicaid Services (CMS) is withdrawing the proposed
rule, “Medicaid Program; Coverage for Rehabilitative Services” (72 FR 45201).
Originally published in the Federal Register on August 13, 2007, the rule
proposed to clarify the definition of Medicaid “rehabilitative services” and
establish new documentation and other requirements.
This rule had been subject to a congressional moratorium put in place by two
laws, the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Pub. L. 110-173)
and the Supplemental Appropriations Act, 2008 (Pub. L. 110-252), that prohibited
the Secretary from taking any action, including publication of a final rule that
was more restrictive with respect to coverage or payment for rehabilitative
services than the requirements in place as of July 1, 2007. Before the
expiration of the congressional moratorium, section 5003(d) of the American
Recovery and Reinvestment Act of 2009 (Pub. L. 111-5), enacted on February 17,
2009, included a “Sense of Congress” that the Secretary should not promulgate as
a final regulation the August 13, 2007 proposed regulation. In light of clear
congressional concern as well as the complexity of the underlying issues and of
the public comments received, CMS decided to withdraw the August 2007 proposed
rule in order to assure agency flexibility in re-examining the issues and
exploring options and alternatives with Congress and stakeholders.
The attached notice went on display at
the Office of the Federal Register yesterday and will be published in the
Federal Register on Monday, November 23, 2009. If you have any questions about
this withdrawal notice, please contact the CMS Office of Legislation. Thank you.
Children's Health
Coverage: Medicaid,
CHIP, and Next
Steps
November
13, 2009
Russell Senate Office Building -
Washington, DC
Sponsoring Organization: Alliance
For Health Reform; Robert Wood Johnson Foundation
Event starts: 12:15pm November
13, 2009 Event ends: 2:00pm November 13, 2009
The Alliance for Health Reform and the
Robert Wood Johnson Foundation are sponsoring a lunch briefing to discuss the
factors involved in children's health coverage, the state of the Children's
Health Insurance Program (CHIP), as well as the implications of the reform
proposals currently under debate in Congress.
Medicaid and the Children’s Health
Insurance Program (CHIP) play a crucial role in the U.S. health insurance system
by providing coverage for more than one in four children. The number of children
in CHIP is at an all-time high, having grown 15 percent over the past year
alone. About half of Medicaid’s enrollees are children. And yet, more than 8
million children remain uninsured today, 70 percent of whom are eligible for
Medicaid or CHIP.
What factors influence children’s
coverage? What are the trends in private sector coverage? How well are the
enrollment simplification and outreach tools included in this year’s CHIP
reauthorization helping reach those children who are eligible but unenrolled?
How much does a child’s coverage depend on where he or she lives? How have
states’ budget shortfalls affected children’s coverage? What is being proposed
in the House and Senate reform bills that could affect children’s coverage in
the future?
Panelists will be:
Jocelyn Guyer of the Center for
Children and Families at Georgetown University Health Policy Institute
Wait a minute -
so a pandemic trumps the alleged free care rule?
October 27, 2009
CMS Free Care Rule for 2009
H1N1 Influenza Vaccination
Medicaid’s long-standing policy is that
Medicaid is not liable for services that are available without charge to the
beneficiary or other legally liable third parties. In general, Medicaid is
obligated to ensure that other legally liable third parties pay primary to
Medicaid.
In the face of the national healthcare
emergency presented by the 2009 H1N1 flu, the free care and third party
liability policies will be applied in the following way:
• Consistent with the Centers for
Disease Control (CDC) guidelines, health care providers accepting CDC funds to
immunize all patients, regardless of insurance, will rely on those CDC funds and
will not bill Medicaid for the cost of administering
2009 H1N1 flu vaccines.
• Health care providers accepting CDC
funds to immunize only patients without other coverage will be permitted to bill
Medicaid for the cost of administering 2009 H1N1 flu vaccines to Medicaid
beneficiaries based on the following criteria:
o Providers with systems capabilities to
bill legally liable third party private insurance or other coverage of
non-Medicaid eligibles and Medicaid beneficiaries must continue to do so.
o Providers without systems capabilities
to bill legally liable third party private insurers or other coverage of
non-Medicaid eligibles and Medicaid beneficiaries may bill Medicaid for services
provided to Medicaid-eligible individuals, but must include in the bills
sufficient information to facilitate Medicaid billing
Republicans refuse to
commit to posting their health care reform bill online
October 30, 2009
Since I published the House Democrats
version of their Health Care Reform bill, below, I thought it fair to publish
the Republican version too. Unfortunately, I was unable to find a copy on
the Internet. After watching John Boehner [R-OH], House Minority Leader at
a press conference on the subject, it became clear I wasn't going to be
successful.
Today during his press conference yesterday House Minority Leader John Boehner
(R-OH) was pressed for Republicans to commit themselves to posting a version of
their plan online at least 72 hours before a final vote on health care reform.
Rep. Boehner balked at the request, saying only that Republicans will
"have our ideas ready."
When pressed as to whether Republicans will unite behind one of their own
plans for reform, Boehner again refused to make any commitments, saying that it
was difficult for Republicans to have a plan when Democrats are controlling the
process. I am not sure you have to be in control of Congress to write your own
plan, but then I did miss a couple of days in 8th grade civics class. Passage of a
Republican plan would certainly be difficult without their control of Congress,
but there is nothing preventing the minority from writing and posting their own
plan online.
Summary of the
Affordable Health Care for America Act [H.R. 3962]
October 30, 2009
Click
here for a .pdf summary of the
House version of health care reform released today by Speaker Pelosi.
House
passes its version of AHCA
Summary
Below
October 30, 2009
House Democrats on Thursday
unveiled the Affordable Health Care for America Act. The
1,990-page
legislation is a combination of bills passed by three House committees
earlier this year. Key tenets include:
· New regulations | New
insurance industry regulations would prohibit insurers from rejecting
customers based on pre-existing conditions. The regulations would also
prohibit annual or lifetime caps on benefits.
· Insurance exchange | The bill
would set up a new national health insurance exchange, a marketplace
where individuals who do not have employer-sponsored insurance would be
able to shop for plans. The exchange would also be open to small
businesses, and more would be able to join each year. Companies with 25
or fewer employees would be able to join in 2013, companies with 50 or
fewer employees could join in 2014, and companies with fewer than 100
employees could join by 2015.
· Public insurance option | The
health insurance exchange would include a government-run public plan.
Federal officials would negotiate payment rates with doctors and
hospitals that accept the plan.
· Employer mandate | Employers
with annual payrolls greater than $500,000 would be required to either
provide health insurance for their employees, or contribute 8 percent of
their payroll to a federal fund to help subsidize employees who purchase
coverage through the exchange. Employers with payrolls less than
$500,000 would be exempt from the mandate.
· Individual mandate |
Individuals will be required to purchase health insurance, or pay a
penalty fee. Some people would be eligible to apply for a hardship
waiver.
· Medicaid expansion | Medicaid
would be expanded to cover everyone whose income is below 150 percent of
the poverty line, or about $33,000 per year for a family of four.
· Affordability subsidies |
People who earn between 150 percent and 400 percent of the federal
poverty level would be eligible for subsidies on a sliding scale to
purchase insurance through the exchange. Those subsidies would ensure
that people who make 150 percent of the poverty level would not have to
pay more than 3 percent of their income in premiums, while those who
make 400 percent of the poverty level could pay up to 12 percent of
their income in premiums.
· Out-of-pocket expenses caps |
New regulations would cap yearly out-of-pocket medical expenses for
individuals at $5,000 and families at $10,000. Those who earn less than
400 percent of the poverty level would have lower caps, on a sliding
scale.
· Tax surcharge | The bill would
help pay for itself by imposing a 5.4 percent tax surcharge on
individuals earning more than $500,000 per year and families earning
more than $1 million.
· End-of-life counseling | The
bill retains a controversial provision that allows Medicare to pay for
voluntary end-of-life counseling.
Questions for Today
October 20, 2009
1. If a school employee is paid
with ARRA funds, can that employee's time be used in a time study that supports
reimbursement for administrative services?
2. If a school district is asked
to participate in the distribution of H1N1 vaccine, can it seek Medicaid
reimbursement if it distributes the vaccine to students who are not Medicaid
recipients without violating the so-called Free Care Rule?
Medicaid: State by State Descriptions & Plans
Medicaid is a
federal-state partnership, with state laws, state regulations,
federally approved state waivers, and approved "state plans" all
creating significant variations from state to state. Listed
below are selected links to information about existing Medicaid
plans and reform proposals within individual states. It is hoped
they will be of general use:
1) to residents seeking basic information about their individual
state.
2) to policymakers and researchers interested in comparing
activities in one state to those in another.
Last night Secretary
Arne Duncan was interviewed on The Colbert Report. Before
the show, Duncan and Stephen Colbert played a game of horse
outside the studio. Highlights include bank shots off a
wall, an apparent foul by the Secretary, and an outside shot
Colbert sank from the studio steps.
In the interview,
Colbert asked Duncan about the education goals of the Obama
Administration. “It’s about having high expectations for
every child,” Duncan explained. “It’s about challenging
everyone to take responsibility—personal
responsibility—students, parents, teachers, principals.”
When asked about No
Child Left Behind, Duncan said:
“No Child
Left Behind did a pretty good job articulating the
problem. I’m much more focused on the solutions. How do
we make sure that every child has a great teacher? How
do we get our best teachers working in historically
underserved communities—rural, inner city. How do we
raise expectations for everyone? At the end of the day,
how do we make sure that every high school graduate is
college ready and career ready? That’s what this is
about. It’s about raising the bar for the country.”
For a look at the roundball game and the
interview, click
here.
Having Trouble
Sleeping?
October 20, 2009
Click
here for the full text of Senator Baucus' America’s Healthy Future Act of
2009 - all 1502 pages of it. It's better than Ambien® or even
Chamomile tea.
Children's Budget 2009
October 6, 2009
First Focus
is a bipartisan advocacy organization that is committed to making children and
families a priority in federal policy and budget decisions. First Focus brings
both traditional and non-traditional leaders together to advocate for federal
policies that will improve the lives of America’s children.
Child health,
education,
family economics,
child welfare, and child
safety are the core issue areas in which First Focus promotes bipartisan policy
solutions.
Each year First Focus produces a
“Children’s Budget” detailing federal funding for children’s programs.
Children's Budget 2009
The federal government funds over 180
different children’s programs, from child health and education to child welfare
and juvenile justice. Children’s Budget 2009 is a comprehensive guide to all
federal spending on children and an invaluable resource for all those seeking to
improve the lives of America’s youth.
This year, Children’s Budget includes a special analysis of investments in
children provided through the economic recovery package, known as the American
Reinvestment and Recovery Act (ARRA). Within the $787 billion ARRA package,
almost $144 billion went to children’s programs. This investment accounted for
18 percent of ARRA spending, a significant increase for America’s children. In
fact, Children’s Budget 2009 reveals that all other federal spending on children
accounts for less than ten percent of the entire non-defense budget.
The key findings of Children’s Budget
2009 include:
For the past five years, less than
one nickel out of every new, real non-defense dollar spent by the federal
government has gone to children and children’s programs.
Children’s spending makes up less
than ten percent of the entire non-defense budget.
The overall share of federal,
non-defense spending going to children’s programs has dropped by twelve
percent over the past five years.
Real discretionary spending on
children has declined by one percent since 2005, while at the same time all
other non-defense discretionary spending has increased by 4 percent.
·Download the Book
The full version of Children's Budget
2009 available to download as a pdf.
Click here.
Request a Free Copy of Children's Budget 2009
If you would like a hard copy of the
publication, click here.
PowerPoint Presentation:
Click here to download the presentation from First Focus's Congressional
Briefing entitled "Children in the Federal Budget."
Health Reform Moving
Forward [well,
moving anyway]
October 6, 2009
Who Is Doing What
The House
The House has been actively engaged in
negotiating the three bill versions and working behind the scenes to craft one
bill for a House vote. Ultimately, House Speaker Nancy Pelosi will need to
reconcile different efforts and decide between emerging disputes, presumably
with input from the White House. In order to do that, Ms. Pelosi has been
holding caucuses tutoring House Democrats on certain aspects of the differing
bill provisions while at the same time providing a forum to hear their
concerns. The most difficult issue shaping the debate appears to be how to hold
on to more generous subsidy levels for low- to moderate- income people while
identifying revenue options to keep the cost of the bill at or below $900
billion over 10 years.
The Senate
During the week of Sept. 28, the Senate
Finance Committee:
· rejected two amendments
providing for a public option,
· rejected an amendment which
would have eliminated the ability of publicly subsidized health plans to offer
coverage for abortions even using only private monies,
· reduced the projected penalties
on individuals who fail to sign up for insurance despite the mandate, and
· continued to consider other
amendments.
The Senate Finance bill currently
standardizes Medicaid eligibility for all individuals and families with an
income at or below 133% of the Federal Poverty Level, equal to an annual income
of less than $30,000 for a family of four and $14,400 for an individual.
After the Senate Finance Committee votes
out a bill this week, Majority Leader Harry Reid will begin to craft a merged
bill combining the Senate Finance Committee's plan with the HELP Committee
bill. Mr. Reid will solicit assistance from the White House and the committee
chairmen in the merger process. As the Senate and House reconcile their
efforts, it is more common for there to be a more open-ended consideration of
amendments to legislation on the Senate floor, rather than through the merger
process. Thus, issues such as the public option are more likely to be revisited
when the final version hits the Senate floor.
Senator Reid is still committed to
having the a bill on the Senate floor by mid-October and announced last
Wednesday that he is canceling the one-week Senate recess, originally planned
for the week of Oct. 12, so that the Senate might more quickly consider health
care reform.
Other amendments to the Senate Finance
Committee bill were:
· An amendment introduced by
Senator Maria Cantwell from Washington, allowing states to collect the tax
credits that would be made available to people between 133% and 200% of the
Federal Poverty Level and use the money to negotiate with insurers for a
state-based public option that would be offered in the exchange.
· Exemption of 2 million people
from the mandate to buy insurance because it would be a financial hardship.
Premiums are not to exceed more than 8 percent of income, lowered from 10
percent of income.
· Reduced or delayed penalties
for individuals who do not purchase insurance. The maximum penalty for a family
not purchasing health insurance was reduced to $800 from $1,900, and would be
phased in gradually between 2014 and 2017.
· Modification of the proposed
tax on high-cost insurance policies so fewer people would be affected. The tax
would apply to policies with family premiums exceeding $21,000, but the
threshold would be $5,000 higher for health plans covering retirees or people in
certain high-risk occupations.
· Protection for several million
older Americans against the loss of extra benefits they receive from private
Medicare Advantage plans.
· Protection of children against
disruption of coverage currently provided under the Children's Health Insurance
Program.
· Agreed to a proposal by Senator
Blanche Lincoln, D, Ark, preventing health insurance companies from taking tax
deductions for executive compensation in excess of $500,000.
· Health and wellness incentives
were outlined, providing discounts for people who quit smoking or lose weight.
White House Leadership Expected
Momentum is building for increased
participation from President Obama. With five congressional committees having
drafted health reform bills, House and Senate leadership will be looking for the
President's input as the bills move through to both chambers for votes. It is
expected that his leadership will be key when the House and Senate bills reach
conference committee. It is at this stage that the administration could have its
greatest input.
Recent filings indicate that
there are enough lobbyists registered to deal with health reform issues to
amount to five lobbyists for every Member of Congress. Apparently
unemployment has not yet hit the Hill.
.
Supreme Court Case Law Library
There are a number of Supreme Court cases that directly affect the issues of
FAPE and "related services." They are now posted on this site in the Case Law
Library.
I will soon post a brief summary of each case for your convenience. The cases
currently in the library are BROWN v. BOARD OF EDUCATION; BOARD OF EDUCATION OF
THE HENDRICK HUDSON CENTRAL SCHOOL DISTRICT; WESTCHESTER COUNTY v. ROWLEY;
IRVING INDEPENDENT SCHOOL DIST. v. TATRO; and CEDAR RAPIDS COMMUNITY SCHOOL
DISTRICT v. GARRET F. I especially recommend that you read the last two.
To gain access to any of the documents in the left hand margin, click on the
document title. Some of these documents are in Adobe format, and will require
Adobe
Reader
to open. If you do not have a copy of this program, you can download one for
free by clicking on the link above.
If you ever need a reminder of why we are in this fight, check this one out
Please feel free to use the information posted here in your efforts to expand
access to Federal Medicaid funding for special education.
Any summary or analysis of any state or federal law or regulation is transmitted
for informational purposes only and not for legal advice. Users should not act
upon this information without seeking the professional advice of a lawyer in the
applicable jurisdiction. An effort has been made to provide useful information,
but the information is not necessarily complete, may be inaccurate, and may not
reflect current legal developments. The provider does not warrant that the
information is complete or accurate and disclaims all liability to any person
for any loss caused by errors or omissions in any summary.
Welcome: This site was originally intended as a place for me to post materials
that were handouts for a national presentation I made in Boston nearly four years
ago. Since that time I have expanded the site to include a library of important
government documents (and this site is searchable by key word, by the way), a
library of relevant Supreme Court cases, regular (well, maybe not so regular, as
I try to keep up with the news as it happens) news updates, and the occasional
editorial. The site also has a new threaded discussion feature. Most of the
links you will need are in the left margin. Enjoy, use and reproduce
materials, and refer freely. Email me with questions, requests, etc.
