January 13, 2017

Senate Votes to Repeal ACA in Budget Resolution

The Senate conducted a “vote-a-rama” Wednesday night until early Thursday morning considering a number of amendments supported by Democrats to S. Con. Res. 3, the budget resolution bill, to stall the total repeal of the 2010 Patient Protection and Affordable Cart Act (ACA). The Senate used the budget resolution bill as a way to repeal the ACA, since the budget resolution requires only a simple majority vote. The ACA was enacted by the same process.

None of the amendments offered by Democrats passed the Senate. The Brain Injury Association of America (BIAA) supported an amendment offered by Senators Mazie K. Hirono (D-Hawaii) and Joe Donnelly (D-Ind.), along with 17 Senate Democrats, to prevent changes to the Medicare and Medicaid programs without a supermajority in the Senate (60 votes). The Hirono-Donnelly amendment created a budget point of order to prevent changes to Medicare that raise the eligibility age, change eligibility requirements, or privatize and voucherize the program. The amendment also was to prevent changes to Medicaid that would reduce state funding from current levels. Any changes to either program would have required a supermajority in Congress. The amendment failed 49-47 with two Republicans voting for the amendment – Senators Susan Collins (R-Maine) and Dean Heller (R-Nev.). A wide range of organizations supported the amendment, including AARP, AFL-CIO, American Federation of State, SEIU, National Education Association, Healthcare Association of Hawaii, Hawaii Public Health Association, and the National Committee to Preserve Social Security and Medicare.

In the end, the Senate voted for the resolution early Thursday morning stripping fees, taxes, and subsidies relating to the ACA. Sen. Rand Paul (R-KY) was the lone Republican opponent of voting on a repeal bill before coming up with a replacement package. Democratic Sen. Dianne Feinstein (D-Calif.) was absent for the vote.

The reconciliation budget for 2017 sets levels of new budget authority, revenues, outlays and deficits for 10 years and projects Social Security funding also over 10 years. The bill directs certain Senate and House committees to each find at least $1 billion in cost cutting over 10 years and estimates the deficit to be over $1 trillion in 10 years as well. The bill largely retains parliamentary procedures such as dynamic scoring, a process under which The Congressional Budget Office (CBO) calculates the economic impact of bills out 40 years. The bill also shows Social Security in the black over the next 10 years. The House is poised to take up similar legislation.

 Lawmakers to Introduce Bills to Repeal Therapy Caps

Lawmakers in both Houses have indicated plans to sponsor legislation to repeal therapy caps. Rep. Erik Paulsen (R-Minn.) and Rep. Ron Kind (D-Wis.) will introduce legislation in the House and Senators Ben Cardin (D-Md.), Susan Collins (R-Maine), Bob Casey (D-Pa.), and Dean Heller (R-Nev.) will introduce the Senate version. Under the Balanced Budget Act (BBA) of 1997, Congress placed an annual cap on rehabilitation services under Medicare. Since enacting the BBA, Congress has acted several times to prevent implementation of a hard cap. BIAA has signed on to the Therapy Cap Coalition’s letter to Members in support of the legislation.

Legislator Introduces Bill for Adult Day Programs

Rep. Barbara Lee (D-Calif.) has introduced H.R. 325 to expand and enhance existing adult day programs for younger people with neurological diseases or conditions, including traumatic brain injury (TBI), in order to support and improve access to respite services for family caregivers who are taking care of individuals with these conditions. She has introduced similar legislation in previous years.

Coalition Sponsors Briefing on Violence and Sexual Assault against Women

The National Science Coalition to Improve Lives is sponsoring a congressional briefing Feb 1. entitled “Violence and Sexual Assault against Women: Reducing its Prevalence via an Evidence-based Prevention Approach.” The briefing will take place from 1 p.m. – 2:30 p.m. in Room 2200 at the Rayburn House Office Building. Speakers include Rep. Gwen Moore (D-Wis.) and nationally-recognized experts on violence and sexual assault against women who will provide an overview of the problem and then discuss the sources of violence in particular settings and situations.


President-elect Appoints VA Secretary

President-elect Donald Trump has appointed David Shulkin, M.D., as Secretary of the Department of Veterans Affairs. He is currently the undersecretary having been appointed by President Barack Obama June 15, 2015. Dr. Shulkin received his medical degree from the Medical College of Pennsylvania and did his internship at Yale School of Medicine, and his residency and fellowship in General Medicine at the University of Pittsburgh Presbyterian Medical Center. He previously served as the president and chief executive officer of Beth Israel Medical Center in New York City and also served as president of Morristown Medical Center and the Atlantic Health System Accountable Care Organization.

U.S. Supreme Court Holds Oral Arguments on the IDEA FAPE Mandate

This week, the U.S. Supreme Court heard oral arguments in Endrew F. v. Douglas County School District, on the meaning of the free appropriate public education (FAPE) mandate for students with disabilities under the Individuals with Disabilities Education Act (IDEA). The case involves a child with autism whom the parents placed in a private school for services the parents believed to be more appropriate than what the public school provided. The parents are seeking reimbursement for the child’s tuition and related expenses. The question the Court is pondering is what educational benefits are guaranteed to a child with a disability by a public school under IDEA.

In response, Senator Patty Murray (D-Wash.), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a statement this week expressing concerns regarding the potential of rolling back fundamental protections and attempts to divert taxpayer dollars from public schools to fund private school vouchers that do not help all students. She is hoping that the Court will preserve Congress’ intent in IDEA to provide students with disabilities meaningful educational benefit from the instruction and services they receive. In November 2016, Senator Murray and Rep. Bobby Scott (D-Va.) led a bicameral group of 118 current and former Members of Congress in filing an amicus brief in the case, arguing that the statute clearly intended to provide meaningful and material educational benefits to students with disabilities so that they may reach their full potential and live independent lives.

ACL Staff Sends Message About Departure

Aaron Bishop, Commissioner of the Administration for Disabilities, acknowledging that his tenure will soon be coming to an end, sent a message to friends and advocates about his time with the newly created Administration for Community Living (ACL). Among ACL’s initiatives and accomplishments, was the transfer of the Federal TBI Grant Program from the Health Resources and Services Administration (HRSA) to the ACL. He supported the transfer and worked with stakeholders accordingly. He expects to be leaving Jan. 20 when the new Administration effectively begins.