Federal Legislative Issues Update - March 2005
March 2005
Washington: Budget Debate Continues
Budget Committee hearings will dominate the congressional agenda through the month of March. Traditionally, the House of Representatives and Senate complete the budget - the general parameters of spending - by the middle of April to start appropriations - the specific amounts for specific programs - in May. Write your representative today to weigh in on the budget debate and support adequate funding for Medicaid, public health, and Title VII health professions programs by going to AOTA's Legislative Action Center. Also see the Federal Legislative Issues Update - February 2005 for information on the President's budget proposals for Medicaid, public health, and Title VII health professions programs.
Medicare cuts have not yet been discussed openly, but are always possible. Funding for non-defense and foreign affairs programs will be tight this year. President Bush has made clear his intentions to reduce the federal deficit in half by 2009 while making the 2001 and 2003 tax cuts permanent. Adding further constraint to available funds is the cost of the ongoing war in Iraq. Unless concerned citizens speak out, Congress is likely to follow the President's lead and focus only on cutting domestic spending-an unbalanced approach to deficit reduction.
Newly Introduced Bills
Repeal of the "$1,500" Therapy Caps
The Medicare Access to Rehabilitation Services Act of 2005 (S. 438/H.R. 916) was introduced by Senators John Ensign (R-NV), Blanche Lincoln (D-AR), Chuck Hagel (R-NE), Susan Collins (R-ME), Orrin Hatch (R-UT), Patty Murray (D-WA), Jeff Bingaman (D-NM), Jon Corzine (D-NJ), and Tim Johnson (D-SD) and Representatives Phil English (R-PA), Ben Cardin (D-MD), Roy Blunt (R-MO), and Frank Pallone (D-NJ) on Thursday, February 17. This bill would repeal the $1,500 annual caps on Medicare Part B outpatient therapy for occupational therapy alone and physical therapy and speech-language pathology combined. A 2-year moratorium was included in the Medicare Modernization Act of 2003 (P.L. 108-173). However, that legislation will expire on December 31, 2005, making way for the cap to be implemented on January 1, 2006, by the Centers for Medicare and Medicaid Services if no action is taken. Use the Legislative Action Center to contact your congressional representatives and ask them to cosponsor the Medicare Access to Rehabilitation Services Act of 2005. AOTA is working with the TriAlliance and other organizations to address this issue.
STOP Stroke Legislation
The Stroke Treatment and Ongoing Prevention Act of 2005 (H.R. 898), or the STOP Stroke Act, was introduced in the House of Representatives on February 17 by Representatives Charles "Chip" Pickering (R-MS) and Lois Capps (D-CA). The legislation aims to ensure that stroke is more widely recognized by the public and treated more effectively by health care providers. The bill will help raise public awareness about stroke; provide critical resources to implement stroke care systems; establish a clearinghouse to collect data and share best practices; and offer medical professional development programs in new stroke therapies. AOTA participates as an active member in the STOP Stroke Coalition, working to address the nation's number three killer and a leading cause of long-term disability.
Arthritis Prevention, Control, and Cure Act of 2005
The Arthritis Prevention, Control, and Cure Act of 2005 (S. 424/H.R. 583) was introduced on February 2 by Senators Kit Bond (R-MO) and Edward Kennedy (D-MA) and Representatives Charles "Chip" Pickering (R-MS) and Anna Eshoo (D-CA). The legislation proposes to strengthen arthritis public health initiatives, which would ensure that more people are diagnosed early and avoid pain and permanent disability. The bill aims to ensure that the limited federal funding for arthritis research is used in the most strategic manner possible. AOTA has worked with the Arthritis Foundation to ensure proper care for the 43 million Americans diagnosed with arthritis.
Allied Health Reinvestment Act
The Allied Health Reinvestment Act of 2005 was introduced by Representatives Cliff Stearns (R-FL) and Ted Strickland (D-OH) in January and by Senators Maria Cantwell (D-WA), Jeff Bingaman (D-NM), and Joe Lieberman (D-CT) in late February. Health care facilities across the nation are experiencing a shortage of allied health professionals, including occupational therapists. The legislation would provide funds to encourage students to enter allied health professions through the development of public service announcements, scholarship and loan programs, incentives to promote racial and ethnic diversity, and the distribution of grants to expand allied health educational programs.
Medicare Mental Health Copayment Equity Act
The Medicare Mental Health Copayment Equity Act of 2005 (H.R. 1125) was introduced on March 3 by Representatives Ted Strickland (D-OH) and Tim Murphy (R-PA). Currently, Medicare discriminates against patients seeking outpatient treatment for mental illness by requiring them to pay 50 % of the cost of their own care out of pocket. This legislation would require such patients to pay only the same 20 % coinsurance required for all other Medicare Part B services by changing the coinsurance rate from 50/50 to 80/20 over 6 years. The Mental Health Liaison Group, of which AOTA is a member, supports this legislation that will reduce the financial burden currently imposed on elderly and disabled Medicare patients who suffer from a mental illness.
Money Follows the Person
The Money Follows the Person bill was introduced on March 6 by Senators Tom Harkin (D-OH) and Gordon Smith (R-OR). The President's New Freedom Initiatives proposals for this year included a Money Follows the Person demonstration project to get states to try that idea. The bill authorizes the secretary of Health and Human Services to provide grants to states to conduct demonstration projects that are designed to enable Medicaid-eligible individuals to receive support for appropriate and necessary long-term services in the settings of their choice. It is important during the Medicaid debate to ensure that adequate funding is given to community-based proposals like Money Follows the Person.
Medicaid Community-Based Attendant Services and Supports Act of 2005
The Medicaid Community-Based Attendant Services and Supports Act of 2005 (S. 401), also known as MiCASSA, was introduced on February 16 by Senators Tom Harkin (D-IA) and Senator Arlen Specter (R-PA). The bill is a piece of Medicaid reform that gives individuals who are currently eligible for nursing home services and institutional facilities equal access to community-based services and supports. The legislation also provides additional funding to states to help them with Medicaid reform of their long-term care systems while increasing the provision of home-and community-based services.
Genetic Information Nondiscrimination Act
The Genetic Information Nondiscrimination Act of 2005 (S. 306) was introduced by Senator Olympia Snowe (R-ME) on February 7 and passed on February 17. Representatives Judy Biggert (R-IL), Bob Ney (R-OH), Louise Slaughter (D-NY), and Anna Eshoo (D-CA) are expected to introduce the house version in the beginning of March. The legislation aims to bar employers and insurers from using a person's genetic information to make employment or insurance coverage decisions. The bill recognizes that all individuals, whether they are healthy or sick, and all medical information, genetic or otherwise, should be afforded the same protections under the law. The Coalition for Genetic Fairness, of which AOTA is a member, is working to secure passage of this legislation in the House of Representatives.
Medicaid Update
Federal and state officials continue to discuss possible implications from restructuring the Medicaid program. The National Governors Association (NGA) recently held their winter meeting in Washington, DC, and Medicaid was the issue at the top of the priority list. NGA has formed a united front to oppose any proposed cuts to Medicaid. Click here (http://www.nga.org/cda/files/0502MEDICAID.pdf) to read "Medicaid in 2005: Principles and Proposals for Reform," a document that looks at the issues, problems, and challenges facing Medicaid in 2005; the outlook for the future; and offers principles and options for reform. AOTA continues to monitor the Medicaid debate and urges you to contact your U.S. Senators, member of the House of Representatives, and the governor of your state and ask them to not to cut Medicaid or make changes that would alter the fundamental structure and protections of the program.
The Individuals with Disabilities Education Act
The Department of Education has concluded a call for public comments on the need for regulations to implement the new version of the Individuals with Disabilities Education Act signed into law by President Bush late last year. The Department also held public forums around the country to gather views and interests prior to developing regulations.
Several AOTA members participated in the forums, following suggestions for comment provided by AOTA.
Congressional Staff Briefing on Public Health
The Coalition for Health Funding, of which AOTA is a member, sponsored a congressional briefing on Friday, March 4, in the U.S. Capitol to ensure that funding for the programs and agencies that constitute the U.S. Public Health Service are adequate to meet public needs. These agencies include the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Agency for Healthcare Research and Quality, Food and Drug Administration, Indian Health Service, and the Office of Public Health and Science. The primary principle of the 50 national health organizations that make up the coalition is that the goal of improved health outcomes for all Americans can only be achieved through strong support for a continuum of biomedical, behavioral, and health services research; community-based prevention strategies; health care services for the medically underserved; and education of a health professions workforce that is in adequate supply.
AOTPAC
The American Occupational Therapy Political Action Committee (AOTPAC) continued its outreach to states with Chair Paul Fontana presenting the keynote address at the Kansas Occupational Therapy Association conference. Fontana also participated in a panel discussion about advocacy and the importance of involvement in state and national associations. AOTA Chief of Public Affairs Christina Metzler, Director of State Affairs Chuck Willmarth, and other Association staff also participated.
The race is on for the 2006 elections. Although it may seem too soon, AOTPAC is already receiving hundreds of invitations and requests for support from candidates-both incumbents and challengers. Whenever possible, we identify events being held in the candidates' home districts and states and work to get AOTA members to attend on our behalf. Last month Lise Faulise, past AOTPAC board member from Rhode Island, attended an event for Representative Jim Langevin (D-RI), where he announced his interest in running for the Senate. At the event, she spoke with Representative Langevin, Senator Jack Reed (D-RI), Rep. Patrick Kennedy (D-RI), Providence Mayor David Cicilinni, and a political reporter-great opportunity to promote occupational therapy.
OT Friends of the Month:
Senator Maria Cantwell (D-WA) for including occupational therapy several times in her comments upon introduction of the bill to amend the Public Health Service Act to promote and improve the allied health professions (S. 473), known as the Allied Health Reinvestment Act.
Senator John Ensign (R-NV) and Representative Phil English (R-PA) for introduction of the bills to repeal the Medicare outpatient rehabilitation therapy caps (S. 438/H.R. 916).
Representative Ted Strickland (D-OH) for submitting for publication in the Congressional Record of March 3, 2005, a letter from the Mental Health Liaison Group, of which AOTA is a member and cosigner. The letter expressed support for the Medicare Mental Health Copayment Equity Act (H.R. 1125).
04/04/05
