Save the Date: Learn About Cuts to Critical Section 811 Housing Programs

On Wednesday March 10 at 1:00 PM (EST) the Consortium for Citizens with Disabilities (CCD) Housing Task Force in conjunction with the Technical Assistance Collaborative (TAC) will host a very important conference call on HUD Section 811 Supportive Housing for Persons with Disabilities program highlighting drastic cuts to the Section 811 proposed FY 2011 budget and critical Section 811 legislation which must be enacted to reinvigorate the program.
What the Call Will Cover:

• The HUD FY 2011 Budget proposal eliminates all funding for new permanent supportive housing units financed through the Section 811 program until the new legislation is enacted. We need your help to advocate with Congress to restore these cuts.
• Currently critical Section 811 legislation is pending in the Senate and has already passed the House with strong bipartisan support. The call will focus on strategies and information you can use to engage your Senator to sign on as a cosponsor to S.1481 and save the Section 811 program.

Please join this call on Wednesday, March 10 at 1:00 PM (EST) to learn how to engage your Senator to cosponsor this important legislation.

Conference toll free call in number:
866-266-3378
Pass code 8224620005#

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New Reports on Medicaid and State Conditions

Kaiser releases a new report on Medicaid’s Continuing Crunch in a Recession: A Mid-Year Update for State FY 2010 and Preview for FY 2011. From the beginning of state fiscal year 2010, fiscal pressures have escalated and additional program reductions have become a necessity to balance state budgets. Half-way through the states' fiscal year, a total of 44 states and D.C. report that Medicaid enrollment and spending trends are above projected levels. Twenty-nine states report that additional mid-year cuts are likely. The February 22nd issue brief reports on interviews with all Medicaid directors about several issues, including the effects of the recession. Their primary concern is the upcoming end of the enhanced federal Medicaid match (as provided in the ARRA) and what that will mean for state budgets.

Kaiser Update on State Fiscal Conditions and Medicaid on How States Used ARRA Enhanced FMAP and State-by-State Measure of State Fiscal Distress.
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Health Summit Yields No Bipartisan Accord and Sheds Light on Divergent Party Philosophies on Health Care Reform

President Obama and congressional Democrats and Republicans debated health care reform for more than six hours February 25th, but as expected, the meeting did not bring the parties closer to a bipartisan agreement on reform legislation. While participants of the summit found some areas to which there were broad agreement, Republicans stated that they wanted the President to scrap the Senate-and House-passed legislation and White House proposal released on Monday and begin anew with an incremental approach to health care reform. Obama ended the unprecedented, day-long session by saying Democrats and Republicans likely could agree on several reform issues, and he called on Republicans to provide solutions over the next month to six weeks on how to extend coverage to more Americans than under the House GOP bill. If a bipartisan agreement cannot be reached, “then I think we have to go ahead and make some decisions,” the president said. “We cannot have another year-long debate on this.” While some expect the next step will be House and Senate Democrats agreement to the Senate bill and then passage of a "reconciliation" bill with fixes negotiated by Congressional Democrats and the Administration, others are reporting that the President has already prepared a fall-back, scaled down version of health care that would provide coverage to 15 million people rather than 31 million that he might consider should other choices fail to gain enough Congressional support.

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HHS Secretary Response to Senate Letter on Medicaid PERM Rates

In response to a letter from Senator Cornyn (R-TX) asking for CMS information on Medicaid's improper payment rates (PERM) for 2007 and 2008, Secretary Sebilius released a letter February 25th detailing state-by-state Medicaid PERM rates for those years. Cornyn had raised the issue because “CMS had reported Medicaid's improper payment rates average between 8.7 percent and 10.5 percent among the states, which is substantial considering the combined federal/state spending on Medicaid reached approximately $438 billion in 2009.” Sebelius reported a national Medicaid error rate of 9.6 percent in its FY 2009 Agency Financial Report. The error rate was based on a weighted average of the states that were measured in FY 2007 and FY 2008.

In her letter, Secretary Sebelius said that that “CMS uses a 17-state rotation so that each state is reviewed once every three years. FY 2007 was the first year in which states were fully measured in each component of the PERM measurement. Therefore, we are only providing information about state rates for FY 2007 and FY 2008; the remaining states will be measured during the FY 2009 rotation.” She reported that for all the states sampled in FY 2007, the average rate was 10.5% with Rhode Island having the largest PERM rate of all sampled states, at 21%--followed by California at 16% and Georgia at 12 %. The combined rate for all sampled states in FY 2008 was 9%--with the top three PERM rates belonging to Oregon at 21%, Washington, D.oiC. at 20%; and Indiana at 17%. Read more!

FMAP Extension Likely on Next Senate Jobs Bill

Senate Majority Leader Reid (D-NV) is following through on his commitment to extend federal FMAP assistance to states through June 31, 2011. Rumored to be in released draft language on a second jobs bill released Wednesday, Reid is including a number of must-pass "health care provisions"that were not included in the first-Senate jobs bill passed Tuesday. In addition to six-month FMAP extension, the next bill in the Senate's job agenda will include an extension of COBRA subsidies for ten months through December 31, 2010 for individuals who have lost employment, an extension of the current fix to Medicare physician rates through September 2010, a full-year extension of the Medicare therap cap exemption, and other Medicare provisions. Stayed tuned for future Alert on when the second jobs bill is introduced and scheduled for a Senate vote. Thanks to everyone who has already responded to ANCOR's previous February 12th alert on FMAP by contacting both of their Senators!
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Administration's New ARRA Relief to States on "Clawback" Medicaid Funds to Cover Dual Eligibles Will Help States Struggling with Medicaid Budgets

The HHS Secretary in a February 18th call to state governors announced that it would provide $4.3 billion in fiscal relief to states by applying ARRA increased FMAP to the so-called clawback payments states pay to the federal government as required by the Medicare Prescription Drug Improvement and Modernization Act of 2003 that added Medicare cost of assuming drug costs for dually eligible Medicare/Medicaid beneficiaries. This temporary adjustment in the clayback payments will be applied from October 1, 2008 through December 31, 2010. The announcement includes a state-by-state table of newly calculated savings to state matching funds.
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State of the States: The State We're In Report Examines Health Reform Efforts in 2009 and Initiatives Underway in 2010

This new Robert Wood Johnson Foundation report it examines how states responded to declining job-based coverage and rising health care costs, as well as Medicaid eligibility and CHIP enrollment in 2009, when many states went forward with meaningful health care reforms despite the fiscal challenges they faced. Read more!

Health Care Summit Thursday Likely to Determine What's on the Table Friday

President Obama invited a host of Congressional leaders to take part in the six-hour meeting, released his health care proposal on Monday, and invited Republicans to do the same. The meeting centers on four health care reform topics — cost control, insurance reforms, deficit reduction and expanded coverage — with Obama, Health and Human Services Secretary Kathleen Sebelius and Vice President Joseph Biden taking turns introducing each topic. While the "bipartisan health care summit" takes place Thursday, the defining moment will come the day after, when Democrats decide once and for all whether they can "go it alone" or try for Republican support to pass a bill.

House Democratic participants include House Majority Whip Clyburn (SC), Speaker Nancy Pelosi (CA), Majority Leader Steny Hoyer (MD), and Representatives Rangel (NY), Miller (CA), Waxman (CA) and Dingell (MI). Republicans include House Minority Leader Boehner (OH), Minority Whip Cantor (VA.) and Representative Camp (MI.), Barton (TX) and Kline (MN).
Senate Democratic participants include Majority Leader Reid (NV), Majority Whip Durbin (IL) and Senators Baucus (MT), Dodd (CN) and Harkin (IA).

Republicans include Minority Leader McConnell (KY), Senate Minority Whip Kyl (AR) and Senators Grassley (IA) and Enzi (WY).

In addition, House and Senate leaders from both parties were each allowed to bring four lawmakers to represent their chamber. House representatives include Representives Becerra (D-CA), Cooper (D-TN), Slaughter (D-NY), Andrews (D-NJ), Boustany (R-LA), Ryan (R-WI, Blackburn (R-TN) and Roskam (R-IL). Senate representatives include Schumer (D-NY), Murray (D-WA), Rockefeller (D-WV), Coburn (R-OK), Alexander (R-TN), John McCain (R-AR), Conrad (D-ND) and Barrasso (R-WY).
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Senate Passes $15 Billion Jobs Bill--First in Series of Job Creation Agenda

After waiving a Republican point of order, the Senate Wednesday morning  passed a $15 billion jobs bill, by a vote of 70-28. The bill which includes  payroll tax breaks, bond-financing for state and local infrastructure projects, a small-business expensing provision, and an extension of federal highway programs, will be sent to the House for a vote.  The House passed a more comprehensive $154 billion jobs bill in December which included a six-month extension of FMAP. 

Before leaving for their week-long President's Day recess, Majority Leader Reid (D-NV) scrapped a larger, bipartisan jobs bill draft by Senate Finance Chair Baucus (D-MT) and Ranking Member Grassley (R-IA) in favor of a series of smaller jobs bills.  Majority Leader Reid is working on several other jobs bills as part of a jobs creation agenda.  A six-month extension of FMAP, as well as extensions of unemployment insurance and COBRA, are being considered for the next jobs bill. However, timing has not been set for the series of bills or content.  Reid must first determine what items must be costed out under new "pay-go rules" and what combination in each package will bring sufficient support to muster a 60-vote cloture rule to end any filibuster efforts, before proceeding.

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Forty-Seven Governors Urge FMAP Extension

A bipartisan group of 42 governors of states and five governors of U.S. territories sent a letter on February 22 urging House and Senate leaders to extend for at least six months the enhanced federal match for Medicaid included in the American Recovery and Reinvestment Act of 2009. The following governors did not sign the letter: Janice Brewer (R-AZ), C. L. Otter (R-ID), Bobby Jindal (R-LA), Tim Pawlenty (R-MN), John Hoeven (R-ND), Mark Sanford (R-SC), Rick Perry (R-TX), and Gary Herbert (R-UT).
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