New Version of "Extender Bill" Passes House and Moves to the Senate

The House sent legislation aimed at spurring job creation back to the Senate Thursday after tacking on language to fully offset the package’s cost.

The move means that the bill will have to return to the Senate for another vote, further delaying implementation of the first portion of the Democrats’ “jobs agenda.”

The centerpiece of the $17.6 billion package is payroll tax relief for businesses that hire new workers, which would cost $13 billion over 10 years. The bill also includes extensions of the Highway Trust Fund, the Build America Bonds program and expense deductions for small businesses.

Certain House Democrats complained that it violated the pay-as-you-go budgetary rule. To make the bill compliant with the rule, the House changed some of the tax provisions that were in the Senate-passed version, including the section on delaying worldwide interest allocation. This is the version that will go back to the Senate for consideration.

Read more!

Senate Continues Consideration of Large Jobs Bill with FMAP Extension--No Votes Until Tuesday March 9th

The Senate spent Thursday resuming consideration of H.R. 4213 disposing of a growing number of pending amendments. Majority Leader Reid considered bringing a motion to close debate. However, he announced that the Senate would continue consideration of the bill Friday and Monday with no roll call votes scheduled until Tuesday, March 9th.
Read more!

President Obama Calling for Passage of Health Care Bill by March 18th

While deadlines on the overhaul of health have been set repeatedly and unmet repeatedly, the President wants the House to clear the Senate-passed bill by the 18th. Having decided on a two-step process to complete comprehensive health care reform, Democrats plan on using the Senate-passed bill as the foundation bill and passing a side-car bill with changes to the Senate bill agreed to by the administration, House and Senate. House Speaker said she could not guarantee a House vote by the 18th, but expected such a vote before the Easter recess. Obama held a meeting Thursday with a mix of House Democrats in order reverse some previous House "no votes" and potential new House "no" votes to gain the necessary 217 votes to clear the Senate bill with reconciliation changes.
Read more!

Senate will take up S. 4213 Thursday morning

The Senate adjourned Wednesday at 8:00 p.m. after considering numerous amendments to the larger $149 billion jobs bill (S. 4213)which extends many tax cuts and federal funding from programs until December 31st -- including temporary federal assistance in the form of enhanced FMAP to states. It will resume consideration of the $149 billion larger jobs bill with FMAP extension on Thursday. Once it passes, the House will take up the measure.


Read more!

Center on Budget and Policy Priorities Issues New Briefs

The March 2nd brief finds that if a state cuts a tax, it generally has to make an offsetting cut to expenditures for a program or service in order to maintain balance. This spending cut is likely to reduce demand in the state just as much as the reduction in taxes may stimulate demand.[1] It is at best a zero-sum game, where the gains in one area are offset by the losses in another. Given states’ balanced budget requirements, neither a broad-based tax cut nor a jobs credit can do much to increase overall economic activity in the state. This tax brief is a good companion to the February 16th CBPP brief A Balanced Approach to Closing State Deficits used in connection with ANCOR's February 18th Audio Conference.

CBPP also released on March 3rd an update on state budget cuts. The report found 45 states making cuts that are harmful to vulnerable populations.
Read more!

GAO March 2010 Report on State and Local Governments' Fiscal Outlook

The new report found that state and local government sectors continue to face near and long-term fiscal challenges and although the sector's near-term operating balance remains negative the federal Recovery Act assistance alleviated pressure with March 2010 operating balance measures showing an improvement compared to January 2009. In the near-term the sector's fiscal position can be attributed to several factors--including steep revenue declines. Absent any policy changes, GAO projects that the sector's long-term fiscal position will steadily decline through 2060. The decline is primarily driven by rising health care costs. Read more!

Democrats Readying to Move on Comprehensive Health Care Plan

Senate Majority Whip Durbin (D-IL) said Wednesday that House and Senate were “coming to closure” on revised language for comprehensive health care legislation that most likely could muster sufficient votes to pass both chambers—most likely using expedited budget reconciliation procedures. He said that Democratic leaders expect to send legislative language by the end of the week soon to the Congressional Budget Office (CBO) for cost estimates. The process would be at least a two-step process with the House passing the Senate-passed bill and both chambers passing House fixes or Administration changes (amendments to the base Senate bill) as a “side-car” reconciliation bill that allows legislation to avoid filibusters and pass with a simple majority.
Read more!

U.S. 9th Circuit Court of Appeals Rules Maintains Injunction Against California Regarding Wage Lawsuit

Thanks to Ron Cohen, President of UCP of Los Angeles, Ventura and Santa Barbara Counties for this news item. The Court today issued a decision against the Schwarzenegger Administration, upholding Federal District Court Judge Wilken's injunction that has blocked since June 2009 the reduction in the state's participation toward in-home supportive worker wages. The decision is a setback to the State of California, which on Monday won a ruling from the California State Court of Appeals on the issue of the Governor's line item vetoes, which that court declared was unconstitutional. The State could decide to appeal the 9th Circuit Court's ruling to the U.S. Supreme Court. The text of 21-page Circuit Court's opinion in Dominguez et al v. Schwarzenegger (formerly Martinez v. Schwarzenegger) and original federal district court case is available on the California Disability Action Center (CDCAN) website at http://www.cdcan.us/.
Read more!

Judge Orders New York City to Move Mentally Ill Out of Large, Institutional Housing

A decision in Disability Advocates, Inc. v. David A. Paterson, by Judge Nicholas G. Garaufis of Federal District Court in Brooklyn, followed his ruling in September that the conditions at more than two dozen privately run adult homes in New York City violated the Americans with Disabilities Act by leaving approximately 4,300 individuals with mental illness isolated in warehouse like conditions. The remedial plan offered by Judge Garaufis, drawn from a proposal presented by advocates was backed by the Justice Department, calls on New York to develop at least 1,500 units of supported housing a year for the next three years in New York City. That would give nearly all residents the opportunity to move out of adult homes. The state is considering an appeal, according to a one-sentence statement from Governor Paterson's officer.
Read more!

FY 2010 State Budget and Economic Survey

ANCOR State Budget Survey Shows Cuts in Services
Members are Urged to Respond to Next Survey

ANCOR asks its members to fill out a quarterly survey that asks questions about your state budgets and how they affect your organization and its ability to support individuals with disabilities. This survey is important because staff can take this information to Capitol Hill when meeting with members of Congress. The answers you give help paint a picture, with real people—the people you support, their families, and your employees -- of what cuts in Medicaid mean to services and supports for individuals with disabilities. In fact, ANCOR encourages you to talk to your federal lawmakers; the more they hear from you the more they will remember how important Medicaid funding is to the work you do.

ANCOR’s most recent survey yielded 65 respondents and a total of 33 of states. Over half of the agencies that responded to the survey received a cut in reimbursement. To deal with cuts, some providers increased the size of living arrangements and decreased the amount of direct support hours.

ANCOR members report the numbers of individuals on waiting lists continue to increase and in many states no funds are available to provide supports to anyone on the waiting list, while provider capacity to take emergency referrals has diminished.

Many providers have been forced to reduce the amount of support to “essential services,” greatly limiting the participation of individuals in their community and their independence. Defining elements of community life, such as access to social, recreational, and religious opportunities, have become limited or eliminated due to transportation and staffing cuts.

This information is just a snapshot of what ANCOR members report. Specific agency names and those making these reports are kept confidential. We hope as more information is collected over time, we can show more data; however, in the mean time, the information collected in this survey is critical to influencing individual members of Congress. Please watch for another survey in April and take the time to respond. Your influence in Congress depends on it!



Read more!

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#

Read more!

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.
Read more!

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.

Read more!

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!
Read more!

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.
Read more!

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).
Read more!

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.

Read more!

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).
Read more!