What to expect from Congress: Important months ahead!


Culminating in a sixteen day government shutdown, the first session of the 113th Congress was considered one of the least productive and most contentious in history. With the entire House of Representatives and one-third of the Senate facing re-election later this year, lawmakers will quickly look to turn the page on 2013. Advancing a more productive agenda in 2014 expects to weigh heavily on Congress’ ability to dispatch the moniker of a “do-nothing Congress”. With midterm elections looming, the next few months represent Washington’s best chance at finding agreement and advancing meaningful policies.

The following offers a snapshot of what to expect on Capitol Hill in the coming months:

Legislative Front

Funding Bills

Approval ratings for Congress plummeted in the fall and highlighted the public’s growing frustration with Washington gridlock. Recognizing the need for a change in tone, leaders in Congress came together to pass a bi-partisan budget deal ahead of the new year.

With hope of continuing the trend, both the House and Senate kicked off the year by unveiling and overwhelmingly passing a spending measure that will fund all parts of the federal government through the remainder of fiscal year 2014. Importantly, the funding bill rolls back a large portion of the “sequester,” the automatic across the board spending cuts to federal agencies and makes key new investments in two areas of importance to occupational therapy:  mental health and early childhood education.

AOTA lent a strong voice to the chorus of organizations who successfully advocated for increased support for domestic, discretionary programs such as the NIH and other research programs, special education and general education, and health workforce training programs, among others.  This spending bill is a significant step forward for these programs and agencies compared to the funding levels under the 2013 sequester, and marks an important return to regular budget order in Congress for the first time in 5 years. After dispatching with a long-overdue FY2014 spending measure, Congress must begin the process anew in order to ready a bill for the start of fiscal year 2015. AOTA will work hard to ensure funding for programs and agencies important to our membership are well represented in FY15 spending discussions.

In the coming weeks, President Obama will address Congress and the American people in his yearly State of the Union speech and then formally present his budget to Congress. AOTA will pay close attention to any new initiatives announced by the President that may affect occupational therapy, as well as look closely for any proposed changes that could harm the profession or cut reimbursement.

Therapy Cap

Congressional action ahead of the new year provided temporary relief against looming SGR cuts and kept a vital pathway to care open for many thousands of Medicare beneficiaries by extending the therapy exceptions process. Beyond its policy implications, the short-term extension was crafted to serve as a mechanism for avoiding any loss in momentum for the broader SGR reform effort and as a means to compel action before March 31st.

Momentum in Congress for reforming the Medicare provider payment system has gained considerably in recent months. Throughout the ongoing debate, AOTA has worked closely with lawmakers to the make the case for repealing the therapy cap alongside any comprehensive legislation.

While legislation in the House of Representatives has, thus far, remained silent on therapy, House leadership has indicated, to us, their intentions to address the therapy cap ahead of full House consideration. AOTA efforts throughout the fall and winter, however, were not in vain, as Senate action produced a more comprehensive bill that does, in fact, include a full repeal of the cap as well as a number of significant reforms to therapy under Medicare. 

Mental Health

As mentioned, the recently passed funding bill included new money for mental health initiatives.  This includes money to train new mental health professionals and a 5% increase in state mental health block grants to be used for early identification and treatment in psychosis programs, programs that have involved occupational therapy.  The bill specifically directs the agencies involved with these programs to report to Congress within three months on how they will be implemented.  AOTA will monitor this implementation and work to ensure that occupational therapy is included.   In addition we will continue to work to advance the Occupational Therapy in Mental Health Act, especially if Congress considers comprehensive mental health legislation before August.

Health Care Reform

Plans under the Affordable Care Act went into effect for the first time on January 1st.  As implementation of this law continues Congress will be watching closely and possibly work to improve or possibly repeal portions of the law.  AOTA will monitor these efforts for how they may affect occupational therapy.  Additionally, AOTA is monitoring state exchanges and implementation of the law, to ensure that enrollees are able to receive the full range of essential health benefits, including habilitation, that were guaranteed under the law.

Political Front

Since Congress started back to work in January, it seems that each day has brought the announcement of a new Congressional retirement.  Many Members, including several of our strongest advocates, have recently announced that they will not be seeking reelection.  The last two elections saw more turn-over in the House of Representatives than in the years prior.  This means that AOTA will be doubling its efforts to build relationships in Congress – both reinforcing the relationships we have with existing occupational therapy advocates and finding new and yet-discovered friends.

To this end, we will be asking you to reach out to your elected officials and make sure that they know the importance and value of occupational therapy.   Additionally, we will be increasing our efforts to raise funds for AOTPAC.  Through AOTPAC, we are able to build new relationships, and, most importantly, we are able to ensure that our Congressional advocates are able win reelection.

Your support for AOTA’s efforts on Capitol Hill has helped propel some of our top priorities to the edge of passage in the 113th Congress. Let’s breakdown the barriers of gridlock and cross the finish line together by making it another record year for grassroots outreach and AOTPAC support.