[NYAPRS Enews] Bazelon: Urgent Action Alert on Proposed Harmful "Reforms"

Thu Apr 7 07:19:01 EDT 2011

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Tidal Wave of "Reforms" in House Budget Chairman's FY 2012 Resolution Would Deprive Vulnerable Groups

 Urge Your Representative to Oppose Medicaid Block Grant, 
Medicare Vouchers and More Damage 

April 6, 2011 -- On Tuesday, April 5, House Budget Chairman Paul Ryan (R-WI), unveiled his fiscal year 2012 budget resolution <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtJDwCvVLDfiDCA9Tu0l0LA6FV8sd0TJmPd5DkO2Aoxe61h1GwhqUq6qFn0Bi2bOY51wB2Vx3FI4x7qbE27barqbi_xmH7xzk4-VnpDVa458UaaPYz-5Fw3otcwLORP31lE=>  termed  "The Path to Prosperity: Restoring America's Promise." His budget calls for $6.2 trillion in cuts over 10 years from President Obama's budget, to be achieved with major structural changes to Medicaid, Medicare and other important federal programs.

The Ryan framework swiftly drew strong criticism from a range of stakeholders, including organizations representing individuals with disabilities, children, families and seniors, and budget experts, as well as Democratic Members of Congress in both chambers. See the statements <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtJ72DaYxcl0X9DLrPzO6pS_0Y4V9zdj7m1Dmws7mRjWuYmaktQWexRkfz00_kXME2Kld5ZCywAUzjq-CFceWhMCULeEchcPfmyEbd7Exj336mAfQgZbFnYsSi0MzVpE3RWupbu7ssiiPwa8aej5rn9wdAPqn2cuBMCFfxwZZjmvmjwUworPDcj2>  of Senators Jay Rockefeller D-WV, and Max Baucus (D-MY) and Representatives Nancy Pelosi (D-CA) and Paul Tonko (D-NY).

The resolution is fast-tracked, with review by the Budget Committee today (see the ranking member's statement  <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtLtZImEdTmNsOG3uj6-FvzVRmgCHJKx792zsrxcjMI5fjR5956Dz5R1PVUpdOcy_tQeEi89L-g-jLzolxjEXOOVAUOF02Ls4OacxzAL6aRee0Z8oJ_DO8plLC2RGfE12e50sDmaXhfyX5We1FYqUPHfyJuteR9oHkz0Ox6U5k2tmlZAFSBXeXRO> and a floor vote next week. See what happens next.  <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtIhc639my0j6r-DTdtksZ8yrNX0Ehko0KvXtMrMELSP7jTrTqW83F_N2hdN5xdAkvnj1RUlM1HHkWmjF9vjLfHft9Fu9HecVTAuBz9awBHE8BEEQ3wYp58OWOPWD77zABckwFEEL7btTzzhPZK211F1dAeu-zkDs0IveYDE6_xbogEgIqrQC72vdgzmbAeECFNGx8AluJNdiQ7c9wJM5W94n8UxQJ6bzYM=> 

Medicaid Revamp Proposed

Although thin on details, the resolution proposes $750 billion in savings by revamping federal Medicaid payments (currently an entitlement program requiring state match) into a block grant to states. (The budget does not specify how the block grant amounts would be calculated.)  Turning the Medicaid program into a block grant would remove federal rules, such as those governing eligibility and benefits, and would greatly increase the number of people who are uninsured and without access to vital medical and mental health care.

The Ryan proposal claims a block grant would be tailored to meet each state's needs  because it provides "flexibility."  However, it would both shift costs to states and place needed health services for safety-net beneficiaries in grave jeopardy. A number of Democratic governors have expressed their opposition  <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtK2rjLCqC2-A5h9zPHX1wNuZ9DRQXyzMNzfMavMKIXIgdD9T6qBP0VmZykVk4FQGsiKcYSEJKR63V3GCI-TbDR6KS7mpMuMtDsR6oVRyJUWUA7OJZr4Biv5RkfFpiIxmeB8fM0XeVJYWqxTfan9LN1Ge1nhA0hpCw4sm0IkYqS5M86CFsOaMl7j> to a Medicaid block grant.

As part of this approach, the proposal would eliminate the Affordable Care Act's expansion of Medicaid, beginning in 2014, to individuals with incomes up to 133% of the federal poverty limit. The expansion is designed to provide access to health services for 16 million Americans, including approximately 4-6 million who have a mental disorder.  This change would save the federal government $431 billion.

Medicare and Various Critical Programs Would Also Suffer

The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) would also be turned into a block grant to states. Like the current TANF program, time limits and work requirements would be applied to recipients of federal housing aid/rental assistance programs.

Additionally, beginning in 2022, Medicare's current fee-for-service system would radically change to a "premium support" voucher model for individuals under 55 years old. Individuals would receive a fixed amount of money to purchase health insurance -- dismantling the current health care program for seniors and individuals with a disability, as it now works for beneficiaries.

Mental Health Funding Threatened

The Ryan resolution also caps non-security discretionary funding at 2008 levels for five years, then ties the cap on the total annual spending of non-security discretionary spending to a percentage of the Gross Domestic Product. Enforcement would be through required across-the-board cuts if spending goes above the prescribed percentage of GDP. This bracket would include SAMHSA programs and services and the vast range of federal public health, education and criminal justice programs.

What You Can Do

The Bazelon Center staunchly opposes the draconian budget and is working in partnership with stakeholder groups to disrupt any effort to block grant Medicaid. 

Please join us today and voice your opposition by contacting your Representative and urge him/her to vote against the budget resolution.  

It is important to also contact your Senators with your concern over the Ryan budget to help secure its defeat in the Senate and spark a balanced approach on federal spending and deficit reduction. See Senators' letter to President Obama <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtKSDeFEcR1fnIFnQ-LQBXrYH4mdMovbQFkM7-QJoMTJRIw7ZbFlYVZB2SHI8DnXjli_Dxz4sR7G_MA0fXyGQWeVG0Kbqme10KjR9k4sHa4AxqVtFZ2FbHPF2vHjsfvWdfVCaNO27-qQ90NzSgiQSwe7F7fYwGIrktEwHOxeZSw2LUwi074i_q-pfFgfWU4sxKf7s7sI43iNhXGTFJojzttxGgzRGZy1bsE=>  on a comprehensive deficit reduction measure.

Talking Points

Medicaid is the lifeline <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtJOwZNmZalkn8Mogu7s_EcW6UMs2zs2_OQrT7cLlmNt7hdwXnHeMOhMvidZ-fu4mIyeVfkwgA3TfphMCS6gRdG65hcvEIGRrdMhIkUM9LCzWzuaJyqZMM0PLBKZ-O8wIKZJUa-Eb4FG-5FWy6kubhJTWB32D1sAgRqSWaose5grQy4PW2G1NLjk>  for low-income people, seniors and individuals with disabilities, including those with a mental illness. It is the primary funder of critical community-based mental health services to help people avoid institutionalization.

*	Medicaid is a critical safety-net program for vulnerable Americans and its integrity must be preserved.
*	Medicaid already has "flexibility" for states (see HHS Secretary's letter to governors <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtIc51RWLro2evcU7x4LvUsGt8Q0WQJG8Wb-uIbbRp8ZiJ67fS5Df05Yshk1i1cAnBt3txfKFyBUyd32hRnJcMXeq3T1cJ5UH0_enW7tvbtnTmrzsasuHWu4dEUEbI9yUdPWt0s24m3QHxEwQX70PMjGqhx7wEaJ9gw=>  outlining Medicaid flexibility and federal support.  A block grant is not the answer.
*	Medicaid has already been cut by states during this economic recession at the expense of providers and beneficiaries. Piling further steep cuts rather than providing additional financial assistance is misguided.
*	Savings proposed by a Medicaid block grant are illusory. Substantial costs would shift to states making the program financially unpredictable and risky for states.
*	Medicare is fundamental to needed health care for seniors and people with disabilities. Drastic cuts in coverage that would result by the "voucher" approach are short-sighted.
*	Federal mental health funding is vital for local community programs and has consistently been underfunded in relation to the needs.

What's Next in the Budget Process?

This is the proposed House Budget Resolution. Budget resolutions are a congressional procedure, do not require a presidential signature and act as a guide to the various committees that write the laws and appropriate funds. The House is expected to approve a resolution closely aligned to this proposal, but the Senate will create its own resolution.

In recent years, the process whereby House and Senate come to agreement on a final resolution has broken down. This year is also expected to end in stalemate. As a result, the proposals in the House Resolution will likely be taken up by the appropriate committees in authorizing and appropriating legislation, which must then be negotiated with the Senate and signed by the President to become law.

The process is likely to be lengthy and it is not possible now to predict how it will turn out. Advocacy around the issues presented in the House Budget Resolution is therefore critical to the final outcome.

Helpful Resources on the Ryan Budget Resolution:

Families USA: A Closer Look: What the House Budget Resolution Means for America's Seniors and People with Disabilities <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtJzsFoIwJ7IAyGaQAqiK0XLIEI-M4VzzlTKmxqwoJxKbfcaG1-L4aNkKzjQLV_HHg2qpSscrx3UuTZwd9Wz_oWPEhn9aLDvgam_zKt91D0N58y3oZxGE51G2phZaSbfoZHLwxHhMju7c3_UgQqpVbQbM8lu8YwUyUU=> 

Center for Medicare Advocacy, Inc.: Why Medicaid Matters to Medicare Beneficiaries and Their Families <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtKIp-oF2YcykrLjKi2AGeOELy2NrTfEmjrjW_zBqlqi7UaV0hxeUeMZmZltEpO-JQ6Im2bTpHXvyUOnzPy7OWNJorNVeAPNehdg_cDuhOVIkj2HB6EqelgWrht51NajHS7Vr67YUYrX995Fp6ypMUoK7xg9b3NaqBs=> 

Center on Budget and Policy Priorities (CBPP) - Off the Charts Blog: Ryan's Rx for Medicaid Means Millions More Uninsured or Underinsured Seniors, People with Disabilities, and Children <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtLkeWLHNc2hkNfiIVEZjh9rjbYeIauzS25pBbZDtJYd27O5lfhsK1DlvPdhmpCYA5ZUaflES69B4lEFB2V5szoCnkwne7w0Iqh5GlVgdoreUgv3eofD2dyuHwClIsOQZvcgrs24hP43eLoT3sVusYY5W5-xXstsZzQ=> 

Chairman Ryan Gets Roughly Two-Thirds of His Huge Budget Cuts From Programs for Lower-Income Americans, by Robert Greenstein, CBPP: http://www.cbpp.org/cms/index.cfm?fa=view&id=3451 <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtJ-gpO11lhcfJ7o9_XIVW05McvcH3WAbyVA9ECEcSIXkQIeMylRoqJqi3RhG7FPBXZUDrmWu1I12pBr7kbO9jkbZrdVpPoYY-QsPkoKmNu7yLDUXlTo2iNInBwFQAQlk6KKykeuDN6IJ1XjCg65HGMu> 

Chairman Ryan's Proposal to Block Grant SNAP (Food Stamps) Rests on False Claims about Program Growth by Dottie Rosenbaum, CBPP: http://www.cbpp.org/cms/index.cfm?fa=view&id=3450 <http://r20.rs6.net/tn.jsp?llr=iri69ddab&et=1105073009973&s=12018&e=001BdKiAf6VZtI9otkCLaQqqHHirUNqQG76hLiAd50P1B-9JXZNg-WiQbm9xt3fqnJZ2iNA7aBTYTbNyX1mvOXm36yyKo8m_v6MAzFEqQs2Gxvvof5IxYyewprcSD-TusBD9Kold-9UGt4W_d693OTgfo_rfSwMT9TU> 

Join Our List 

Join Our Mailing List <http://visitor.constantcontact.com/email.jsp?m=1102861738536> 

The Bazelon Center also produces its Mental Health Policy Reporter,  available exclusively online and to our email subscribers. The Reporter supplements the Bazelon Center's Action Alerts by providing a periodic bulletin on significant policy developments that affect people with mental illnesses. Your subscription to our Action Alerts automatically entitles you to receive the Reporter. 

Laurel Stine
Director of Federal Relations
202-467-5730 ext. 325
laurels @ bazelon.org <mailto:laurels at bazelon.org> 

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