Headlines of the week
Some U.S. House members launch proposals to defund health reform
Republicans in the U.S. House are beginning their first in a series of efforts to defund health reform, The Washington Post reports. Rep. Denny Rehberg of Montana offered an amendment to the budget bill, which funds government through the end of the current fiscal year, that would prohibit the administration from using any of the funding to implement the Affordable Care Act. Colorado Rep. Cory Gardner plans to offer an amendment that would prohibit use of federal funding "'to pay the salary of any officer or employee of the Department of Health and Human Services who develops or promulgates regulations or guidance' on the health insurance exchanges," the Fort Collins Coloradoan reported Thursday.
While the majority of funding for health reform was appropriated in the Affordable Care Act itself, the House Republican strategy is to prohibit federal agency use of their operational funds for health reform purposes. That effectively prevents agencies like the Department of Health and Human Services from issuing regulations and guidance that states need to set up health insurance exchanges, and implement Medicaid expansions and consumer protections. The Center on Budget and Policy Priorities notes the budget amendments would be to render federal government unable to enforce new consumer protections created under health reform, prevent cost-containment and anti-fraud initiatives from moving forward and bar further implementation of Medicare improvements.
Arizona may eliminate 250,000 from Medicaid
Arizona doesn't need federal approval to restrict Medicaid eligibility and cut 244,000 low-income childless adults from the program, Health and Human Services Secretary Kathleen Sebelius said in a letter issued Tuesday.
Arizona voters approved expanding Medicaid to cover childless adults, among other groups of low-income Arizonans, in 2000, The New York Times reports. Because Arizona added Medicaid coverage for the 244,000 childless adults through a so-called Medicaid demonstration waiver, Sebelius said nothing in Medicaid law or the Affordable Care Act prevents Arizona from allowing the waiver to expire Sept. 30. Gov. Jan Brewer proposed the cut to save $541 million, nearly half of Arizona's budget shortfall for the coming year. She now faces her next hurdle, which will be to undo an expansion that was voter-approved.
Due to ongoing budget constraints around the country, many states were watching closely for Sebelius' opinion on the proposed cut to see whether it offered them additional flexibility to make cuts to their own programs. The Affordable Care Act (ACA) requires states to maintain eligibility standards as they were in effect the day the ACA passed, March 23, 2010. Any change that would make eligibility for Medicaid or the Children's Health Insurance Program more restrictive is barred by the ACA and jeopardizes all of the state's federal Medicaid funding. Last month, 33 governors and governors-elect sent the President, House and Senate leadership, and Sebelius a letter asking them to lift the requirement to maintain eligibility.
Sebelius' opinion does not waive the maintenance of eligibility requirement. It is limited in scope and deals very specifically with Arizona's ability to allow its current waiver to expire. As the National Health Law Program notes, it also does not allow the state to end other waivers before their expiration dates.
Follow the Health Care Program's work at the Colorado Legislature on new website
A feature on our website introduced this week shows the bills the Health Care Program staff is following at the Colorado General Assembly. The information is updated throughout each day lawmakers are in session.
Bill would add unnecessary barrier to receiving public benefits
A bill pending in the Colorado General Assembly would add a requirement that applicants for public benefits who are older than 18 produce a Social Security card. The measure, House Bill 11-1149, is sponsored by Rep. Cindy Acree, R-Aurora. The Colorado Center on Law and Policy opposes the bill for the following reasons:
- The state already verifies Social Security numbers, and requires proof of identify and citizenship.
- According to the Denver Department of Human Services, there is no evidence undocumented or otherwise ineligible immigrants are accessing public benefits in Colorado.
- Colorado's stringent identification and citizenship verification requirements for those applying for public benefits are already so burdensome that many U.S. citizens have trouble meeting them. Many people spend weeks or months trying to secure the necessary documents. For vulnerable people, the time and expense required can be prohibitive.
- It takes weeks to replace a lost Social Security card, and doing so requires an in-person visit to the Social Security Administration.
- Counties, already struggling with processing benefits applications timely can ill afford additional administrative requirements that lengthen the application process.
- The requirement would make it even more difficult for Coloradoans to access help in the aftermath of the worst recession since the Great Depression.
The bill will be heard in House State Affairs on Thursday, Feb. 24. A list of committee members is on the state website.
Health programs for low-income communities at risk of cuts
Funding for several federal programs that improve the health of low-income communities would be cut under President Obama's proposed Fiscal Year 2012 budget, the National Health Law Program reports. Some of the at-risk programs include:
- Racial and Ethnic Approaches to Community Health (REACH), a $39 million cut
- Health Homes/Childhood Lead Poisoning Prevention/Asthma, a $33 million cut
- Preventive health and Health Services Block Grant: a $100 million cut
- Healthy Communities Program, a $22 million cut
Analysis examines U.S. House proposed cuts to current year federal budget
The Center on Budget and Policy Priorities on Thursday released an analysis that details the level of cuts being proposed by Republican leadership in the U.S. House to the current fiscal year budget. These include cuts to education, weatherization, WIC, Head Start, and clean water and the environment. The report provides state-by-state analysis of cuts to Title I education spending, Mental Health and Substance Abuse Block Grants, and low-income housing projects, among many others.
States get demonstration grants to lead the way on exchange IT
It's critical that Colorado and other states build and operate effective, efficient, consumer friendly information technology systems to manage state-based health insurance exchanges. The IT systems must be able to provide consumers with easy to access information about health insurance options, including handling eligibility, enrollment, premium tax credits and cost-sharing reductions to premiums. They also must operate seamlessly with Medicaid and Children's Health Insurance Programs so that eligible people are enrolled in those programs.
The Department of Health and Human Services announced this week that Kansas, Maryland, New York, Oklahoma, Oregon, Wisconsin and a consortium of New England states will receive a total of about $241 million to design and implement model IT systems for health insurance exchanges that other states may adopt. The grants will help to assure states don't have to go it alone in designing the IT infrastructure of their exchange. Each grant focuses on a different exchange service or IT design component. Oklahoma, for instance, is developing a model for exchange eligibility and enrollment.
More information about the grants is available on the federal government's health reform website.
Health Law and Policy Update is issued weekly by the health staff of the Colorado Center on Law and Policy. Subscribe by e-mail or read previous editions.
Health Care Director
Health Care Attorney
Released Feb. 18, 2011