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Health Care Reform
On Oct. 29, the U.S. House of Representatives released the legislative text of the Affordable Health Care for America Act (H.R. 3962). On the plus side, the bill contains the CLASS provisions that we’re fighting for, along with an intriguing $6 billion authorized over the next few years for nursing homes with Medicare and Medicaid dually-eligible residents which also meet certain quality requirements. The bill codifies the improvement in Medicare reimbursement for non-therapy ancillaries, which will tend to benefit not-for-profit skilled nursing facilities (SNFs).
On the other hand, the bill has provisions to 75 percent of the 2010 Medicare payment update for skilled nursing facilities (SNF) and increased civil monetary penalties for survey deficiencies. Neither of these provisions were in Senate draft measures, so we’re working to keep these provisions out of whatever final health care reform legislation clears Congress.
We expect the bill to come to the House floor this week, maybe by Wednesday. Most likely, there will be severe limits on floor amendments. That’s why we don’t anticipate the opportunity for objectionable provisions to be removed at that stage.
On the Senate side, we still do not have a “zipped” measure ready to go to the Senate floor, but floor action there is possible the week of Nov. 9. We are working intensely with several senators to keep CLASS provisions in the combined Senate measure that will go to the floor.
Housing Reform
Michelle Norris from National Church Residences did a terrific job on Thursday, testifying before the Senate Banking Subcommittee on Housing, Transportation and Community Development. Her testimony highlighted how our Section 202 reform bill (S. 118) would streamline senior housing development and preservation, combine affordable housing with supportive services and bring the program into the 21st century. Several senators who heard her statement will be instrumental in moving this legislation forward.
Housing and HCBS Appropriations
Our spending bills are still hanging fire. The Transportation/HUD conference report hasn’t been finalized – one rumor has it that House-Senate conferees cannot agree on provisions that would restrict passengers from carrying firearms on Amtrak trains. But we are hopeful that a conference agreement will soon be ready for a final vote in the House and Senate.
We are less optimistic about the Labor/HHS bill that funds Older Americans Act programs, since the bill hasn’t pass Congress on a stand-alone basis in recent memory. We are working to lock in the funding gains passed by the House in July into whatever omnibus spending bill or continuing resolution Congress may pass in December.
Since there still are several outstanding 2010 spending bills, Congress passed a continuing resolution this week to keep the government functioning through Dec. 18. Ho, ho, ho.
That’s all for now. We’ll keep you posted on what’s happening as soon as we hear about it.
Here’s the latest from Capitol Hill on issues relating to aging services:
Fiscal 2010 spending bills: Members of the House and Senate are working on final provisions of the U.S. Department of Housing and Urban Development HUD appropriations bill for this fiscal year. As we understand it, it’s the Department of Transportation side of the bill that ’s difficult for the conferees to resolve, not the housing side.
While we don’t expect the final bill to come to a final vote in the House and Senate next week, a vote shouldn’t be too far away.
The Labor/Health and Human Services bill that covers Older Americans Act program is another story. The bill passed the House during the summer, but hasn’t gotten to the Senate floor. There seem to be no immediate prospects for it to be taken up.
Since the continuing resolution under which most federal programs are operating will expire at the end of next week, Congress will pass a new continuing resolution to keep programs going at current spending levels until Dec.15.
Congress also will need to act soon to raise the public debt limit, and we understand that they will set it at $13 trillion. That’s enough to avoid another increase before next year’s election. The debt limit reflects deficit spending that’s happened, but running up against the limit would prevent the federal government from borrowing any more money.
Housing reform: Next Thursday, the Senate Banking Subcommittee on Housing, Transportation and Community Development will hold a hearing on “Modernizing Affordable Housing for Seniors and People with Disabilities.” Michelle Norris, Senior Vice President for Development and Acquisition of National Church Residences, will speak on our behalf. This is a great sign sign of progress on our signature Section 202 reform legislation, S. 118.
Health care reform: We are still on tenterhooks as the Senate leadership deliberates over the elements to be included in the health care reform bill that will be sent to the Senate floor.
Because the “zipping” process is not yet complete, we won’t be seeing Senate floor action on the bill next week or probably the week after.
There’s no decision yet about including the CLASS provisions. Many of you participated in this week’s targeted grassroots activity on this issue. If your senator indicated support for CLASS, a thank you note would be in order. If he/she was undecided, a note appreciating his/her time would be in order, with a repetition of the advantages of CLASS.
That’s it for now. Have a great weekend.
The health care reform timetable is being pushed back a little more. Floor action now will not begin until the week of Oct. 26, at the earliest, in the Senate.
The House also is not ready to take up health care reform on the floor as there are three competing proposals for a public option that still have to be scored by the Congressional Budget Office (CBO). It no longer appears that the House will necessarily wait for the Senate, as the time for floor action is getting short. Congress will only be in session for two weeks in November, taking off a week for Veterans Day and one for Thanksgiving.
An interesting side note: to resolve controversy over the cost of fixing the physician reimbursement system, that issue has been broken out of health care reform legislation and will be considered as separate legislation on the Senate floor next week. Whatever resolution is reached may then be folded back into health care reform.
Iara Woody created an excellent chart about how health care reform measures may affect AAHSA members as providers. It comes with a caveat that several of these provisions, such as the employer mandate, are among the most controversial issues in health care reform and are very much subject to change as the legislation progresses.
On the appropriations front, some progress is being made in reconciling the provisions of the House and Senate spending bills covering senior housing, so we may see final passage of that measure soon. However, there will be another continuing resolution at the end of this month to cover federal programs whose appropriations have not yet passed, and that measure will cover home and community-based services under the Older Americans Act.
That’s the latest.
A quick update this week, as not much has changed over the past week on our issues.
Housing Appropriations for 2010: We hear that House and Senate appropriators are close to a final 2010 spending bill. The final bill may include some of the provisions in our Section 202 reform legislation. We will let you know as soon as we see what the conferees provide for funding levels for senior housing this year.
HCBS Appropriations: No Senate floor action yet on the Labor/Health and Human Services appropriations bill that funds Older Americans Act programs. The OAA programs are currently covered under a continuing resolution, which expires at the end of this month, but we have been assured that Congress will pass another continuing resolution to keep federal programs in operation.
Health Care Reform: The Senate Finance Committee has scheduled a vote for Tuesday on its amended health care reform package. The measure will then have to be merged with the Health, Education, Labor and Pensions (HELP) Committee measure that contains the Community Living Assistance Services and Supports (CLASS) plan. After that, the Congressional Budget Office (CBO) will have to score the merged legislation before a floor vote can take place.
It appears that the timetable for the full Senate to vote on health care reform is slipping to the week of Oct. 26. It also seems more and more likely that the House will not vote on its bill until after the Senate finishes with its legislation. But prognosticators still predict that a final bill will be ready to go to the White House by Christmas Eve.
Because it is critical for the CLASS plan to survive the merger of the Finance and HELP Committee drafts, we have scheduled a Senate Call-In Day for Tuesday, Oct. 13, from 8:30 a.m. to 6 p.m.
Please join us in urging senators to contact Senate Majority Leader Harry Reid (D-Nev.) to let him know that the CLASS provisions be included in the health care reform bill that goes to the Senate floor.
We also participated in a rally with several other stakeholder groups on Capitol Hill on Thursday in support of the CLASS plan. The rally featured an appearance by one of our members, Donna Taylor of Phoenix, Ariz., who spoke of the difficulty she experienced in obtaining care for members of her own family, even as a professional in our field, and the difference CLASS benefits would have made.
Following the rally, Ms. Taylor was interviewed by Joe Shapiro, a reporter for National Public Radio’s All Things Considered, who was doing a story on the CLASS plan.
That’s it for now.
If you have today off, enjoy! We’re hard at work in D.C.
