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Current Issues: What We’re Watching

Money Follows the Person (MFP)

  • This program has helped over 88,000 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 IMPROVE Act may be the last chance to extend the program in this Congress. 

Electronic Visit Verification (EVV)

  • EVV is a tracking system that requires electronic verification of Medicaid-funded personal care services, which states will be required to use by January 1, 2019. 
  • On May 16, 2018, the Trump Administration released guidance about EVV, but questions and concerns remain, including the harmful impact these changes will have on the independence of people with disabilities.
  •  Congress passed a bill extending the deadline to implement EVV for a year.  A delay would allow advocates more time to work with Congress to address the concerns of people with disabilities.  Next step: the President must sign the bill for it to become law. 
  • State EVV Good Faith Effort Exemption Requests should be submitted to CMS.

Administrative Attacks to the Affordable Care Act

  • The Administration continues to issue executive orders, participate in lawsuits, and change federal regulations that undermine the ACA’s goal of making insurance affordable and accessible for everyone.
  • These attacks remove key parts of the ACA that protect people with disabilities from discrimination, including provisions that stop insurers from denying coverage or charging more for people with preexisting conditions, or seek to get rid of the law as a whole.

Institutions for Mental Diseases

  • Congress proposed changing Medicaid rules to begin paying for inpatient mental health care services in psychiatric facilities, also called Institutions for Mental Diseases (IMDs).
  • HHS has also issued guidance that allows funding for services to Medicaid beneficiaries while residing in IMDs. 
  • These change are concerning because they will allow states to spend money on these facilities, rather than on services that can keep people with disabilities in their homes and communities.  The policy has been a payment exclusion for using Medicaid funds for institutions for mental diseases (IMDs).
  • 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

Changes to Public Charge

  • The Department of Homeland Security (DHS) issued a proposed 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  public comment period closed on Dec. 10, 2018.  DHS must now review and respond to the comments received.

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
  • Republicans advanced a plan for the budget that would continue efforts to “repeal and replace” the ACA.

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