Policy Corner: May 26, 2023
Categories: Policy Corner Archives
House and President Negotiate Debt Ceiling Bill
Although time is running out, House/Senate leadership and the Administration have yet to come up with an agreement for passing legislation to raise the debt ceiling to pay the federal government’s bills. U.S. Treasury Secretary Janet Yellen has told Congress that the debt ceiling must be raised by June 1st or the federal government will run out of money to pay its existing debts, which includes Social Security checks that are issued the first of the month. The authority is necessary to pay bills in accordance with approved spending through the fiscal year 2023 appropriations process. Several proposals have been floating around, including freezing spending on domestic programs, while slightly increasing funding for the military and veterans’ affairs, and cut spending for Medicaid, Supplemental Nutrition Assistance Program (SNAP), special education, employment, and other health and disability-related programs as called for in H.R. 2811, Limit, Save, Grow Act, that the House has passed.
On Wednesday, several disability and aging organizations, including the Consortium for Constituents with Disabilities (CCD), held a virtual “Save Medicaid” event with advocates and Members of Congress. Senator Bob Casey (D-Pa.) and other panelists joined the event to discuss the harmful impacts that cuts to Medicaid will have on older adults, children, and people with disabilities.
Senators Announce BENES 2.0 Act
This week, U.S. Senators Bob Casey (D-Pa.) and Todd Young (R-Ind.) introduced the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) 2.0 Act to simplify Medicare enrollment for seniors and people with disabilities. The bill would require the federal government to provide advance notice to people approaching Medicare eligibility about basic Medicare enrollment rules, filling a longstanding gap in education for older adults and people with disabilities. Currently, people who miss their initial Medicare enrollment window may pay lifetime late enrollment penalties. In 2020, about 776,000 people with Medicare were paying a Part B Late Enrollment Penalty (LEP) and the average LEP amounted to nearly a 27 percent increase in a beneficiary’s monthly premium. In December 2020, Congress passed key provisions of the original BENES Act, which updated Medicare enrollment rules to end needless gaps in coverage.
In addition to Senators Casey and Young, the current bill, yet to be made available, is cosponsored by Debbie Stabenow (D-Mich.), Susan Collins (R-Maine), Kyrsten Sinema (I-Ariz.), Tim Scott (R-S.C.), Sherrod Brown (D-Ohio), Tina Smith (D-Minn.), and Mike Braun (R-Ind). BIAA supported this bill in the previous Congress.
Lawmakers Circulate Sign-on Letter to CMS for Regulatory Relief
The Regulatory Relief Coalition reports that over 42 U.S. Senators and 120 U.S. Representatives have signed on to a letter to the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) urging the agency to finalize a proposed prior authorization reform rule that was proposed in December 2022. The letter is open until June 9 for lawmakers to sign the letter. The letter thanks CMS for taking action toward ensuring timely access to health care by proposing rules to streamline prior authorization (PA) protocols for individuals enrolled in federally-sponsored health insurance programs, including Medicare Advantage (MA) plans.
Lawmakers urge CMS to promptly finalize and implement these changes to increase transparency and improve the prior authorization process for patients, providers, and health plans. Lawmakers also urge CMS to expand on these proposed rules by: (1) establishing a mechanism for real-time electronic prior authorization (e-PA) decisions for routinely approved items and services; (2) requiring that plans respond to PA requests within 24 hours for urgently needed care; and (3) requiring detailed transparency metrics.
The Brain Injury Association of America (BIAA) has supported the Improving Seniors’ Timely Access to Care Act legislation in the past that puts patients first by ensuring they do not needlessly face barriers to medically necessary care created by some MA plans that overuse or misuse prior authorization, particularly as it pertains to the rehabilitative needs of individuals with brain injury.
CMS Releases Proposed Rulemaking for Medicaid and Managed Care
Last month, the Centers for Medicare and Medicaid Services (CMS) released two notices of proposed rulemaking (NPRM): 1) Ensuring Access to Medicaid Services (Access NPRM) and 2) Managed Care Access, Finance, and Quality (Managed Care NPRM). The rules are to help eliminate barriers that people with disabilities face while trying to access quality health care through Medicaid and Children’s Health Insurance Program (CHIP). If the proposed rules are adopted, they would establish national standards for access to health care, regardless of whether health care is provided through managed care plans or directly by states through fee-for-service, as well as transparency for Medicaid payment rates to providers, including hourly rates and compensation for certain direct care workers.
Both NPRMs can be downloaded from the Federal Register. The public comment period ends July 3, 2023.
Invite Your Congressional Members to be Member of CBITF!
As January began a new Congress, members need to be encouraged to join the Congressional Brain Injury Task Force (CBITF), co-chaired by Reps. Bill Pascrell, Jr. (D-N.J.) and Don Bacon (R-Neb.), which conducts valuable work in promoting issues and the needs of individuals with brain injury and their families among Congressional members. The Task Force is bi-partisan and is comprised of both members of the U.S. Senate and U.S. House of Representatives. While we often think of March Awareness Day activities as their primary function, their efforts far exceed that by circulating “dear colleague” letters to gather support for funding prevention; research; military and veteran’s care; and state grants for improving service delivery. The Task Force holds briefings throughout the year, often in collaboration with another caucus, to promote education and awareness about issues relating to brain injury, such as promising research, fall-related brain injuries, and women’s issues relating to brain injury. Members also sponsor and co-sponsor critical legislation.
How can you help with recruitment? You can contact your Representative and Senators via their websites (or phone) and submit a request that they join and why it is important to you. Members who would be interested in joining may contact Rep. Pascrell’s office.