August 1, 1997..................................................................................................Number 53
Washington, D.C.- Today the Senate passed a bill that provides 24 billion dollars over the next five years to help the nation uninsured children get coverage through a block grant to states. Financed by an increase in the tobacco tax, there will be a total of 48 billion dollars over the next ten years.
In a bipartisan effort, Senator Orrin Hatch (R-UT) and Senator Ted Kennedy (D-MA) cosponsored the Senate bill that many people didn't think had a prayer of passing. The original proposal increasing children's health coverage by 20 billion dollars over the next five years when they introduced the bill less than four months ago. The new bill is called the Child Health Insurance and Lower Deficit Reduction Act.
Senator Hatch praised the bipartisan efforts of many people both in and out of Congress, including Senator Kennedy, Representative Nancy Johnson, Bob Matsui and Marion Wright Edelman from the Children's Defense Fund. "CDF has a prayer", said Senator Hatch "Dear Lord, please help me. My boat is so small and the ocean is so big. Today, the children's health boat is a little bigger and more seaworthy than it was just a few short months ago. For America's children, today the ship has come in".
Provides $24 billion in the first 5 years, and $24 billion in the next five years. The funding levels add up to $39.65 billion over the next 10 years because certain Medicaid costs have been taken off the top.
It is financed in part through a tobacco excise tax increase. There is no increase in the first two years. For the next two years, there is a 10 cent per pack increase. In the fifth year, FY 2002, and thereafter, the tax is increased by 15 cents a pack.
Funds can be used for state block grants, or expanded Medicaid, or both. Funding can be provided for community-based health delivery systems, such as Community Health Centers Funds cannot be used for any other purpose than those enunciated in the bill.
Funds are distributed by a formula that is initially based on the number of low-income uninsured children in the state and in subsequent years blended with the number of children in the state. There is a geographical adjustment for the costs of providing services. No state will get less than $2 million/year. Funds are made available for three years, and unused funds can be redistributed among other states.
If a state chooses to insure new children not now eligible for Medicaid under Medicaid, they may receive increased Federal matching equal to 30% of the state share, with an 85% cap on the Federal contribution.
A detailed process is laid out for submission of the State plan, or amendments thereto. Secretarial approval is deemed unless she notifies the state within 90 days that it is disapproved.
States determine eligibility. Generally, children can be covered up to age 19 and at 200% of Federal Poverty Level. However, states which currently are at that coverage level may expand their program up to 250% of FPL. Covered children cannot be eligible for Medicaid now and cannot be covered now under group health plans.
States must show they are: a) trying to cover Medicaid eligibles first; b) not substituting the new plan for current group health plan coverage; and c) covering Indian eligibles.
States will be required to enunciate strategic objectives and performance goals, submit an annual report, and be subject to regular evaluations as to effectiveness of the plan.
States must provide coverage which is either equivalent to a "benchmark package" or a equivalent to a "benchmark-equivalent" package, and they can provide even more from a long list of services, which includes transportation costs, mental health, home care and dental.
The state may also get approval from the Secretary to offer other coverage. Current non-Medicaid state plans in NY, Florida and Pennsylvania are grandfathered in.
Cost-sharing amounts must be published in the state plan, and imposed under a public schedule. Variations based on family income should not disadvantage lower income families.
No cost-sharing for preventive services. If the child has income below 150% of Federal Poverty Level (PPL), the state may not impose a premium above that which would have been charged under Medicaid, and any deductible or other cost-sharing must be "nominal", as in Medicaid.
States cannot change their Medicaid eligibility standards in effect as of June 1, 1997.
Abortion coverage is specifically precluded, except for rape, incest or life of the mother cases.
Washington, D.C.- In a surprise move this week, California Congressman Frank Riggs proposed an amendment called the Riggs IDEA Limitation Amendment, which, if enacted, would threaten the recent hard fought victory for IDEA's passage. The amendment would limit the penalties to states that fail to provide special education services to individuals who are 18 years old or older, and reside in adult State prisons. This amendment flies in the face of the spirit of IDEA, and the civil rights of all people with disabilities and it is important that any attempt to dilute the provisions to IDEA be resisted.
Secretary of Education Richard W. Riley expressed his concern that this amendment would "undermine the very important bipartisan and bicameral agreement on IDEA that President Clinton signed into law less than two months ago". Secretary Riley expressed his opposition to efforts to undermine IDEA, including the new provisions allowing resolution to issues regarding educational services in adult prisons.
The amendment appears to be the result of pressure from California Governor Pete Wilson, who has refused to comply with the provisions of IDEA in regards to eligible persons in the prison population.
It appears that the Labor/ HHS and Education Appropriations Bill, to which this amendment will be offered, will not be considered until the Congress reconvenes after Labor Day. The House, under the leadership of Congressman Goodling, and the Senate, has been working non-stop to increase the funding for IDEA. Let them know you support and appreciate them, and let them know that the integrity of IDEA should be preserved.
As a result of welfare reform, children now receiving SSI and all those applying now and in the future must meet new eligibility rules. More than 260,000 children have received notices that their cases will be reviewed and that they might no longer qualify for SSI cash benefits.
Those most likely to lose SSI are children with mental health or behavior problems, but some youngsters with developmental disabilities and chronic health conditions are also up for review.
Every child who gets a denial can go through the appeal process and keep cash benefits and Medicaid during that time.
What Families Can Do:
If denied, make sure you appeal within the 10-day limit. Keep good records of calls, letters, reports, especially those explaining your child's disability. Get a medical exam for your child from a doctor who knows SSI and disability. Find a free lawyer at the first denial stage. If you are an advocate for our kids, join your state or local SSI group (families, Legal Aid lawyers, PEA, foster care and child and disability advocates, pediatricians). Call the following individuals if you need more information;
Jonathan Stein (215.981.3742), Richard Weishaupt (215-981-3773), Mary Noland (215-381-3788) of Community Legal Services or call Julie Justicz at the American Bar Association SSI project, 312/988-5765.
Clinton says Happy Birthday to ADA
The ADA is seven years old, and President Clinton made note of this by issuing a birthday greeting on the anniversary. The President said " Across America, barriers in communication, architecture and attitudes are tumbling... but communities and businesses must do more to ensure that all Americans, regardless of their disability, can live and learn, work and play along side their fellow Americans".
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