Policy Corner: March 13, 2020

Congress Sends Older Americans Act to the President

The U.S. House of Representatives accepted Senate changes to the Supporting Older Americans Act of 2020, H.R. 4334, and passed the act via unanimous consent. The legislation has been sent to the president’s desk for his signature. The bill contains provisions that were added in a House committee with regard to screening for traumatic brain injury (TBI) after a fall and to include TBI in health promotion activities.

Congress and the Administration Address the Coronavirus Crisis

President Trump signed into law an $8.3 billion funding bill to help treat and prevent the spread of novel coronavirus (COVID-19). Most of the money went to the Department of Health and Human Services (HHS), which this week announced funding to create diagnostic testing for state and community health centers to treat underserved populations.

The House of Representatives is considering legislation addressing access to free tests, expanding paid sick leave, and providing food assistance to those in need. The food assistance portion of the legislation addresses the need to feed children who get free lunch at school in instances where the school has closed. The bill establishes and increases required standards to protect health care workers. The Senate is expected to return Monday to work on a bill, although many Senators disagree with the House approach.

Meanwhile, the president has blocked the use of Medicaid to respond to crisis after California and other states requested to expand Medicaid to cover medical services. In previous emergencies, Congress and the administration loosened Medicaid rules to allow states to meet resulting needs. Several federal agencies, including the Centers for Disease Control and Prevention, have since posted information regarding the virus and the programs they administer. 

Advocates and Senators Call for Policymakers to Ensure the Needs of Persons with Disabilities in the COVID-19 Pandemic

Disability advocacy organizations are holding Congressional leadership responsible for overseeing federal disaster response programs to ensure that the rights and needs of people with disabilities and those with access and functional needs are taken into account in this latest emergency. Concerns have been expressed about the lack of American Sign Language interpreter or captioning that is visible on screen so that people who are deaf or hard of hearing can be informed of the latest news about the illness and the actions they must take for their own safety and the safety of others. Many people with disabilities depend on personal care attendants or prescription medications for which they may have only limited quantities. If they are unable to access these vital services and supports in a timely fashion, this could result in severe harm or even death for people with disabilities.

Sens. Robert Casey, Jr. (D-Pa.) and Jack Reed (D-R.I.) have sent a similar letter to Vice President Pence about the need to ensure that all Americans, including those with disabilities, those with limited English proficiency, and those who are aging, have information in accessible formats. Several senators have also written noting the number of Americans who rely on Medicaid home and community-based services. They have asked for guidance to ensure that workers in these programs are adequately equipped to protect those to whom they provide services.

Representatives Call for CMS to Delay Weakening Medicaid NEMT Services

Reps. Buddy Carter (R-Ga.), Tony Cardenas (D-Calif.), Tom Graves (R-Ga.), and Sanford Bishop (D-Ga.) are urging the Centers for Medicare and Medicaid Services (CMS) to delay any decisions to weaken the requirement that states provide non-emergency medical transportation (NEMT) to Medicaid beneficiaries. CMS has indicated that it plans to release a Request for Information asking about the necessity of NEMT benefits in Medicaid. NEMT provides transportation services to health care appointments and other needed services for individuals with disabilities or those who are elderly. Federal Medicaid regulations require that states ensure transportation to and from providers. Some states have received approval from CMS to waive the benefit for the new adult group made eligible under the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) as part of their Medicaid expansion waivers. The president’s budget for fiscal year 2020 included a proposal to change the NEMT benefit from a mandatory Medicaid benefit to an optional one. Lawmakers have introduced the Protecting Patients Transportation to Care Act, H.R. 3935, to protect this benefit.