Domestic Weekly Update March 2, 2010
New and Urgent in This Week’s Update
Latest from Washington, DC, and Beyond
Organizational Reminders and Updates
Call Congress in Support of Medicaid Reimbursement RatesAs Congress prepares to move forward on health reform, a key issue still remains unresolved with regard to the Medicaid program. If and when health reform passes, it will include a substantial expansion of Medicaid. Everyone below (at least) 133 percent of the federal poverty line will be eligible to enroll in Medicaid beginning in 2014. The Congressional Budget Office estimates that this expansion alone will cover 15 million people who currently have no health insurance. Make no mistake, this Medicaid expansion is the result of your tireless work over the last year (and years) in pushing our elected leaders to address the needs of low-income individuals and families. However, even if Medicaid is expanded to include more people, more must be done to ensure that they actually get adequate care. One way is by expanding community health centers (CHCs), which serve a large number of Medicaid patients. Again your hard work has paid off because if and when reform passes, it is likely to include a large increase in CHC funding. But even more is needed to ensure care for low-income communities. Once of the key challenges in Medicaid is finding doctors to pay Medicaid patients. Medicaid is very much like a single-payer program; doctors treat patients and then are reimbursed for their services by state and federal governments. Unfortunately, the reimbursement rate for doctors who treat Medicaid patients is very low. Medicaid doctors are only paid 66 percent of what Medicare doctors are paid for primary care. As a result, because doctors are not required to take Medicaid patients, many refuse to do so. In 2008 only 40 percent of physicians accepted all of the new Medicaid patients that came through their doors. This means that Medicaid patients have fewer outlets to seek medical care than do Medicare and private insurance patients. The House health reform bill, the Affordable Health Care for America Act (H.R.3962), addresses this problem by raising Medicaid rates up to Medicare rates within three years of implementation. The Senate bill does not contain a similar provision, nor does President Obama’s proposal. Because the Senate bill is the base bill for reform, any changes in Medicaid reimbursement rates will have to be made in a companion reconciliation bill (see below). Patients who have health insurance but no doctor to see are no different from the uninsured. Reform only works if people have coverage and access to care. TAKE ACTION: Call Congress tell them to pass meaningful health reform now. Tell them final reform must include the House provision that raises Medicaid provider reimbursement rates to Medicare levels. Contact the House and Senate health aides you have developed relationships with over the last year and tell them that Medicaid patients need doctors to go to just like everyone else. Remind them that passing reform and raising Medicaid reimbursement rates in the final health reform bill will help doctors get paid, patients get care, and our society get better. If you are not sure who your representatives are, you can search by zip code on the RESULTS elected officials page. Making the Case for Finishing Reform in the Media (March Action Preview)Last Thursday, President Obama hosted a White House Health Summit to get bipartisan comments on his proposal for health care reform. Jos Linn, Meredith Dodson and Alan Gold watched part of the summit and posted their comments on RESULTS’ Facebook page. It is doubtful that the summit changed the dynamic between Republicans and Democrats on health reform. During the summit, the Democrats were united in their desire to move forward on the president’s proposal and the Republicans were united in their desire to start over. Probably the most significant exchange of the day came at the end when President Obama basically told health reform opponents that his patience has run out; if they are not willing to come to the table with realistic and meaningful ideas, he will move forward without them. Tomorrow, President Obama plans to unveil more details about his health reform plan as well as the procedural path to passing it. More than likely, this procedural blueprint will include passing the bill with budget reconciliation (see section below). However, even with this procedure, passage of health reform is not assured; the House of Representatives only passed their version of health reform by 2 votes back in November. It is going to take a concerted push by everyday people around the country to see this through. Because this is a critical time for passing health reform, our March Action will focus on helping you make this push. As you know, the media can play a powerful role in influencing policy. Members of Congress pay attention to letters to the editor, op-eds, and editorials from their local papers. This gives us the opportunity to shape the debate and push back against the falsehoods about health reform. For too long, the health reform process has been driven by special interests and Washington lobbyists — it is time for the people to have their say! TAKE ACTION: Tell Congress to pass reform now! Take the March Action (we will have the March Action sheet available online by the end of this week). Send a letter to the editor or op-ed to your local paper, urging Congress to pass health reform now. It is time to do what it right for all Americans and not what is best for insurance companies and Washington lobbyists. Be sure to call on your representatives and senators by name in your letter or op-ed. If you want to take action today, you can use our online alert to send a letter directly from the RESULTS website. Also, visit the White House health reform site, which has an interactive tool with state-by-state data on the benefits of health reform. Also, see our updated health reform summary chart that has a side-by-side comparison of the House, Senate, and White House health reform proposals. March 4 Call-In Day for Child Care, Head Start, and NutritionPresident Obama’s fiscal year 2011 budget requests increased funding for programs to assist children and families. These requests include a $1.6 billion increase in funding for the Child Care and Development Block Grant (CCDBG), a $989 million increase in funding for Head Start/Early Head Start, and a $1 billion increase in funding for child nutrition. In an effort to see these increases included in the final budget, National Women’s Law Center is urging call this Thursday to Congress in support of the president’s budget numbers for these programs. TAKE ACTION: Call your representatives and senators offices on Thursday, March 4, using NWLC’s toll-free number (888) 460-0813. Tell the person answering the phone that child care, Head Start and child nutrition are essential programs for children and families. Urge that the senator/representative support the increases for these programs proposed in the President’s budget. For background see our Head Start and child care online alert and our child nutrition online alert. If you are not sure who your representatives are, you can search by zip code on the RESULTS elected officials page. America’s Safety Net Is Breached — Action on Unemployment Insurance StalledThanks to all our RESULTS advocates who took action last week to tell Congress to extend unemployment insurance benefits (UI), COBRA benefits, and the increased federal contribution to states for Medicaid. Despite substantial advocacy by many organizations, Senate action for a 30-day extension was stalled by the action of two Senators. Sen. Jim Bunning (R-KY) continues to put a hold on the extension bill, arguing that lawmakers should come up with a plan to pay for it, and Sen. Jon Kyl (R-AZ) is blocking the bill as a way of forcing a cut in the estate tax. As a result, beginning yesterday, long-term unemployed Americans began to lose UI benefits. The National Employment Law Project estimates that 1.2 million people are in danger of losing federal aid by the end of March. In addition to extending UI and COBRA benefits for unemployed Americans, the $10 billion extension package would have delayed a scheduled 21 percent pay cut for doctors who see Medicare patients. That cut is now in effect. In response, Senate Majority Leader Harry M. Reid (D-NV) and Finance Committee Chairman Max Baucus (D-MT) have released a larger bill that would drop the short term extensions and instead extend UI and COBRA benefits for the rest of 2010. Fortunately, the bill also extends the increased federal Medicaid payments under the American Recovery and Reinvestment Act for another six months, through June 2011. The measure would also devote $31 billion to revive expired tax breaks supported by Republicans. The Senate is expected to bring the bill to the floor this week. TAKE ACTION: Contact Congress and tell them to pass extensions of unemployment insurance benefits, COBRA and Medicaid’s FMAP increase now! UI and COBRA should be extended through the end of 2010 and the FMAP for Medicaid should be extended another six months through June 2011. Congress must not neglect unemployed Americans and cash-strapped states, which need help now or face more hardship in the coming months. Use our online action alert to make your phone calls and send e-mails. What Is Budget Reconciliation, Anyway?As you know, much is being said about using the budget reconciliation process for passing health reform. Reform opponents are calling it the “nuclear option” and “the end of the Senate.” Such doomsayers have forgotten their history. Let’s set the record straight on what reconciliation is and how it will be used in health reform. Budget reconciliation was created in 1974 as part of the Congressional Budget Act. It is procedure designed to bypass the filibuster in the Senate to pass changes in mandatory spending (i.e. entitlements) and tax policy. While both chambers in Congress use the procedure, it is essentially a way to pass budget and tax deals with only 51 votes in the Senate. Only matters that impact the federal budget may be included in reconciliation bills and final decisions in the Senate as to what may or may not be included (i.e. what is “germane”) are made by the Vice President, who is also the President of the Senate. Since 1980, the process has been used 23 times, 17 under Republican presidents and 6 under Democratic presidents. Here are some of the major bills (but not all) that have been passed using reconciliation:
In the current debate, budget reconciliation has actually been on the table for nearly a year. The FY 2010 Budget Resolution passed in April 2009 included instructions that allowed Congress to use reconciliation to pass health reform and changes to student loans/Pell Grants. Therefore, this process is not new, not unprecedented and with regard to health reform, not a surprise. In fact, proponents of the public health insurance option have been pushing House and Senate leadership to use reconciliation for months; leadership ignored those pleas until recently. Only after the January election in Massachusetts produced a stalemate in the Senate, and the House refused to pass the Senate bill without changes, did reconciliation become a preferred option for finally passing reform. Therefore, three things must happen in order for health reform to pass (this assumes no Republicans will vote for reform and that the House will not pass the Senate bill without any other action).
Timing of which action comes first and when the president would sign the bills are still not clear, but essentially this is the process likely to be used. Some Republicans claim that reconciliation should not be used here because health care reform covers such a large part of the economy. However, the reconciliation bill would not be used to pass comprehensive health reform. Comprehensive health reform has already passed both the House and the Senate and will be enacted when the House passes the Senate bill (step 1 above). The reconciliation bill is only being used to amend parts of the Senate bill that 1) House members object to and 2) are permitted under reconciliation rules. In other words, reconciliation is only being used to complete the final compromise between the House and Senate health reform bills. We understand this is very complicated but we will try to explain the process as best we can as things move forward. If the president’s plan that he will outline tomorrow differs significantly from this scenario, we will let you know. RESULTS’ Very Successful Outreach WeekendLast weekend was a very successful weekend for RESULTS Outreach. It started last Thursday morning when RESULTS Director of Domestic Campaigns Meredith Dodson appeared on CNN Newsroom. She appeared with author, spiritual teacher, and RESULTS Board member Marianne Williamson to discuss how everyday citizens are working to break the logjam in Washington and pass legislation that helps low-income children. It was an impressive and inspiring segment. If you did not see the program, you can watch a tape of the program on YouTube. After the CNN broadcast, Meredith, RESULTS founder San Daley-Harris, and other RESULTS staff traveled to the Sister Giant seminar in Los Angeles, which was created by Williamson. RESULTS presented for 3 hours during the conference and generated 500 letters in support of foreign and funding priorities. After the presentations, 235 people signed up to get involved with RESULTS, including 61 people who want to get involved as RESULTS activists. We will be working to follow up with those who signed up in the coming days and weeks. Congratulations to Meredith, Sam, and everyone else who made this a very successful weekend! If you know someone who would like to get involved with RESULTS, please contact Jos Linn or Meredith Dodson for next steps. Quick NewsLow-Income Tax Credit Extensions on Hold Now. President Obama’s FY 2011 budget request includes funds to extend temporary tax credit improvements that were enacted in the American Recovery and Reinvestment Act (ARRA). ARRA raised Earned Income Tax Credit (EITC) for families with three or more children, and increased the benefits for married couples. ARRA also expanded the Child Tax Credit (CTC) for 13 million children in low-income working families. However, because of the focus on health reform and jobs initiatives, these provisions and other budget items are on the back burner for now. It is expected that they will come up in the coming months as part of the budget process. RESULTS will keep you posted as things develop. Don’t forget to take the February Action. If you have not taken the February Action yet, please take a few minutes this week to write a letter to your representatives and senators urging them to pass health reform and expansions to low-income tax credits in 2010. Remind them that these investments will help millions of individuals and families struggling in poverty, help create jobs, and revive our economy. Find links to background information on Health Care for All and Economic Opportunity on the RESULTS website, including brief PowerPoint presentations on our work on health reform and low-income tax credits. AnnouncementsPlease Submit Your Group Planning Forms. Go to the RESULTS Group Resources page to find the RESULTS 2010 Group Planning Materials. Use the forms available to help with your group planning. Once you have completed your Group Planning Form, e-mail, mail or fax a copy to Meredith Dodson at the RESULTS DC office. As always, if you have any questions or need help with your planning, please contact Meredith or Jos Linn. Listen to the RESULTS Website Tour Online. Listen to the February 18 conference call that gives you a tour of the RESULTS website. You can also find the link to the call on our Multimedia Resources page. Donations Always Welcome. RESULTS and RESULTS Education Fund always welcome your financial contributions. Your support helps us do the work we do. Use our easy, breezy online donation form to make your contribution. Upcoming Events(Click to see a complete calendar) March 4: Call Congress Day for Head Start, child care and child nutrition. Call representatives and senators toll free (888) 460-0813. March 13: RESULTS Domestic National Conference Call, 12:30 pm ET. April–May: New Activist Orientation. Four sessions: April 5, April 19, May 3, May 17. Call (712) 432-3100, passcode 761262. Contact Lisa Marchal to sign up and for more information. June 20–22: RESULTS/RESULTS Educational Fund International Conference, Washington Marriott Hotel, Washington, DC. RESULTS Contact InformationMain Office: (p) (202) 783-7100, (f) (202) 783-2818, 750 First Street NE, Suite 1040, Washington DC 20002. Domestic Legislative and Grassroots Support Staff: Meredith Dodson, x116 (dodson@results.org); Alan Gold, x106 (gold@results.org); Jos Linn, (515) 288-3622 (jlinn@results.org). The RESULTS Domestic Update is sent out every Tuesday over e-mail to RESULTS volunteers and allies all over the country. The purpose of these updates is to inform and activate RESULTS activists to take action on our domestic campaigns. |