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Current Issues: What We’re Watching

Money Follows the Person (MFP)

  • This program has helped over 75,000 seniors and people with disabilities move out of institutional settings and into the community with their families and loved ones, leading to better health outcomes, improved quality of life, and less state spending
  • MFP expired in 2016 and states are running out of funding and will result in the elimination of this program if Congress does not reauthorize it
  • The EMPOWER Care Act may be the last chance to extend the program before all remaining funds run out.

Electronic Visit Verification (EVV)

  • EVV is a tracking system that requires electronic verification of Medicaid-funded personal care services. 
  • States are required to use EVV systems by January 1, 2019. 
  • People with disabilities worry that EVV will violate their privacy and limit their independence. 
  • On May 16, 2018, guidance about EVV was issued, but questions and concerns remain.  
  • Bills have been introduced in Congress to extend the deadline to implement EVV and to require a formal notice and comment process on EVV rules. A delay would be an important step and will give advocates more time to work with Congress, CMS and the states to address the significant concerns with EVV and its potential impact on people with disabilities.

Changes to Public Charge

  • The Administration is about to issue a rule that could prevent individuals with disabilities and their families from legally entering the country.  
  • This rule could also prevent individuals living in the U.S. from accessing needed services.  
  • The proposed rule has not yet been released.  Once it is, be ready to comment!  

Institutions for Mental Diseases

  • Congress recently proposed changing Medicaid rules to begin paying for inpatient mental health care services in psychiatric facilities, also called Institutions for Mental Diseases (IMDs)
  • This change is concerning because it will require states to spend money on these facilities, rather than on services that can keep people with disabilities in their homes and communities.
  • The House is likely to move forward with a bill that includes this proposal soon.

Medicaid Work Requirements

  • The federal government has approved, and is reviewing more applications from multiple states to impose work requirements for people to receive Medicaid
  • These requirements are supposed to exempt people with disabilities, but they fail to do so for a variety of reasons and will result in the loss of Medicaid for many families
  • The Trump administration is trying to add work requirements in other crucial public benefits as well that would hurt people with disabilities and make it easier for this change to happen in Medicaid

Administrative Attacks to the Affordable Care Act

  • The Trump Administration continues to issue executive orders and change federal regulations that undermine the ACA’s goal of making insurance affordable and accessible for everyone (most recently, on June 19, 2018, with a new regulation to offer association health plans)
  • These attacks remove key parts of the ACA that protect people with disabilities from discrimination
  • The Department of Justice is now arguing that it’s “unconstitutional” to prevent insurance companies from discriminating against people with pre-existing conditions, which could allow insurers to start denying coverage to people with disabilities and raising their costs for insurance.

The Federal Budget for Fiscal Year ’19

  • The President’s proposed budget would cut billions of dollars from Medicaid and health care subsidies
  • The proposal also includes policies and budget cuts that would disproportionately harm people with disabilities from accessing health care

We need to keep up our advocacy and educate our Representatives on the importance of Medicaid to people with disabilities. Take action now!