Policy Corner: September 14, 2018

Conferees Approve Labor-HHS Appropriations Package: CR Included

This week, the House and Senate Appropriations conferees agreed to a Conference Report for fiscal year 2019 funding for the Department of Defense, and the Department of Labor, Health and Human Services (HHS), Education and Related Agencies. This package of bills also includes a short-term Continuing Resolution (CR), which will provide continued funding until Dec. 7, 2018, when all twelve appropriation bills can be signed into law.

The conferees agreed to the Senate recommendation for an additional $4 million for National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) to fund competitive research grants that help individuals with disabilities, with a particular emphasis on seniors, to maintain or improve independence. Both House and Senate Appropriation Committees supported language opposing transferring the program to the National Institutes of Health (NIH), as proposed by the President’s budget. The Administration for Community Living’s (ACL), Traumatic Brain Injury (TBI) program is level funded at $11,321,000. This amount funds both the Protection & Advocacy and State grants to improve service delivery. This is the same amount as the current year, which is $2 million more than the previous year and above the President’s budget request. The same is true for the Centers for Disease Control and Prevention’s (CDC) National Injury Center for the TBI program, which is funded at $6.75 million, the current level of funding.

The conferees include $300,000 to establish and carry out activities of the Family Caregiving Advisory Council as authorized under the RAISE Family Caregivers Act (P.L. 115-119). The conferees also include $300,000 to establish the Advisory Council to Support Grandparents Raising Grandchildren created by the Supporting Grandparents Raising Grandchildren Act (P.L. 115-196) passed in July. The Department of Health and Human Services is the lead agency for the council.

While conferees did not retain the additional $2 million for Injury Control Research Centers as recommended by the House, the program is level funded ($9 million). The President’s budget had proposed elimination. The conferees did not concur with the House recommendation to fund CDC’s Injury Center $40 million for opioid surveillance and prevention activities. The conferees did agree to $5 million for the CDC to establish the National Neurological Conditions Surveillance System, as authorized in the 21st Century Cures Act (P.L. 114-255).

As the Violence Against Women Act expires Sept. 30, the conferees extended the program through Dec. 7 under the stopgap spending bill. Earlier Thursday, Rep. Elise Stefanik (R-N.Y.) filed legislation that would extend the current Violence Against Women Act for six months and give lawmakers more time to address potential changes.

House May Consider Expanding the Definition of Full-Time Worker for Insurance Purposes

The House Majority Leader Keven McCarthy (R-Calif.) has indicated that the House may pursue legislation to expand the definition of full-time worker to one who is employed 40 hours per week, rather than 30 hours as defined under the Affordable Care Act (ACA) for health insurance purposes. Under the ACA, a full-time worker is one who is employed at least 30 hours per week. If the employer carries more than 100 full-time employees, the ACA requires healthcare coverage to be provided to those defined as full-time. H. R. 3798, the Save American Workers Act of 2017, was introduced last September to raise the hours to determine full-time employment to 40 hours per week, thereby relieving employers of the cost of providing health insurance, which would leave many employees without coverage.

Arizona Governor Appoints Senator to Fill McCain’s Vacancy

Arizona republican Governor Doug Ducey appointed former Senator Jon Kyl Sept. 4 to fill Senator John McCain’s term due to his death. Kyl previously represented Arizona in the Senate from 1994 to 2002. He has indicated that he does not plan to run when the term is up.

BIAA Opposes CVS Caremark Drug Coverage Policy

The Brain Injury Association of America (BIAA) joined more than 90 organizations in a letter to CVS Caremark opposing a new policy that would discriminate against individuals with disabilities and chronic illnesses. Last month, CVS announced that they would offer new insurance plans that exclude drugs if they exceed a subjective “cost-effectiveness” threshold determined by an assessment model developed by the Institute for Clinical and Economic Review in determining whether treatments fall below a $100,000 “cost per quality-adjusted-life-year” limit. This type of cost effectiveness analysis discriminates against people with disabilities and other vulnerable groups, including older adults, because it assigns higher value to people in “perfect health” than people in less-than-perfect health. The letter states, “policy decisions based on cost-effectiveness ignore important differences among patients and instead rely on a single, one-size-fits-all assessment. Further, cost-effectiveness analysis discriminates against the chronically ill, the elderly and people with disabilities, using algorithms that calculate their lives as ‘worth less’ than people who are younger or non-disabled.”

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action.