Policy Corner: March 15, 2019

President Releases FY 2020 Budget Recommendations

On Monday, the President released his fiscal year 2020 budget recommendations to fund government beginning Oct. 1. The budget reflects significant cuts to non-defense discretionary programs, which refers to programs that receive an annual appropriation. The overall cuts to the U.S. Department of Health and Human Services (HHS) amounts to 12 percent, should the budget be enacted. The cuts include $2 million to the HHS’ Administration for Community Living (ACL) Traumatic Brain Injury State Partnership Grant Program and the Protection and Advocacy Grant Program combined. While the Administration does not propose to move the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) to the National Institutes of Health (NIH) as proposed last year, it does reflect a $19 million cut to the program.

In addition, the budget recommends cuts to Independent Living ($8 million); Family Caregiver Support Services ($31 million); and Lifespan Respite Care ($1 million). The budget recommends elimination of these ACL programs:

• Falls Prevention Program (-$5 million)
• Chronic Disease Self-Management Program (-$8 million)
• Limb Loss Resource Center (-$4 million)
• Paralysis Resource Center (-$9 million)

The budget also calls for major cuts in Medicare and Medicaid. The proposal calls for $845 billion in cuts to the Medicare program over the next ten years by eliminating waste, fraud and abuse; and by cutting payments to certain hospitals and other providers, such as reduced payments to hospital outpatient departs and teaching hospitals for patients who cannot pay their bills. The Administration’s proposal would curb Medicare beneficiaries’ appeal rights and increase the amount many would pay for needed prescriptions. The budget plan reduces Medicaid by nearly $140 billion over the next ten years by eliminating Medicaid expansion to those states which expanded their programs under the Affordable Care Act (ACA); imposing work requirements; and turning the program over to the states through a block grant or a per-person cap for Medicaid recipients. The Money Follows the Person would be eliminated under this proposal.

The budget also recommends cuts in public assistance programs: the Supplemental Nutrition Assistance Program (SNAP), known as food stamps by $220 billion over ten years; basic assistance for people with disabilities through Social Security Disability Insurance and Supplemental Security Income; supports to poor families with children through Temporary Assistance for Needy Families (TANF) program; and the elimination of the Social Services Block Grant. The budget calls for deep cuts in public housing and would raise rents for millions of low-income households receiving rental assistance (including both those living in public and private housing).

The President’s budget is the first step in the process. Appropriations hearings will soon start in the House and the Senate as Congress begins its own process of passing appropriation bills.

Senators Introduce the ABLE Age Adjustment Act

Senator Bob Casey, Jr. (D-Pa.), along with Senators Jerry Moran (R-Kans.) and Chris Van Hollen (D-Md.) and have once again introduced the ABLE Age Adjustment Act, S. 641, to make ABLE accounts available to individuals who acquired his or her disability prior to his or her 46^th birthday. ABLE savings accounts allow people with disabilities to save for disability expenses and long-term needs without risking many of their federal disability benefits. Currently, this program is available only to those who acquire their disability prior to their 26^th birthday. The Brain Injury Association of America is on record supporting this bill.

Senator Offers a Resolution to Protect Pre-Existing Conditions

This week, Senator Mazie Hirono (D-Hawaii) asked unanimous consent that the Senate proceed to and pass S. Res. 94 to urge the Department of Justice to protect individuals with pre-existing medical conditions by defending the Patient Protection and Affordable Care Act (Public Law 111-148; 124 Stat. 119) in Texas v. United States, No. 4:18-cv-00167-O (N.D. Tex.), in which the plaintiffs seek to invalidate protections for individuals with pre-existing medical conditions). Senator John Barrasso (R-Wyo.) objected.

CDC Announces New Data on Sports and Recreation-Related TBI

This week, the Centers for Disease Control and Prevention (CDC) included in the Morbidity and Mortality Weekly Report (MMWR), a new report, Emergency Department Visits for Sports and Recreation-Related Traumatic Brain Injuries Among Children—United States, 2010-2016 that reported that an estimated 283,000 children seek care in U.S. emergency departments each year for a sports- or recreation-related traumatic brain injury (SRR-TBI). The report found that:

Contact sports contributed to nearly half (45%) of the SRR-TBI visits examined.

• Males and children aged 10-14 and 15-17 years were most likely to sustain a SRR-TBI.
• Activities with the highest number of SRR-TBI visits included: football, bicycling, basketball, playground activities, and soccer.

Congress Adjourns

The Senate and the House of Representatives are adjourning and will return to work on Monday, March 25. The next Policy Corner will be published March 29.

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