National Alliance on Mental Illness
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(800) 950-NAMI; email@example.com
For Immediate Release, 20 Oct 99
Contact: Chris Marshall
The House of Representatives last night passed the Work Incentives Improvement Act (HR 1180), by an overwhelming bipartisan margin of 412 to 9. To find out how your representative voted, you can click on http://clerkweb.house.gov/cgi-bin/vote.exe?year=1999&rollnumber=513. This impressive margin of victory is the product of months of advocacy on the part of people who have experienced first-hand the unfairness of the current SSI and SSDI programs - many of them people with severe mental illnesses and their families. NAMI members that have taken the time to contact their members of Congress about this issue are to be congratulated for their efforts.
The House Republican leadership has now pledged quick action for a House-Senate conference committee to resolve the differences between HR 1180 and the bill that passed the Senate in June, S 331. The strong bipartisan majority that supported this legislation in the House bodes well for the Work Incentives Improvement Act (WIIA) to be signed into law before Congress adjourns in a few weeks. However, all the parties involved, including the White House, are still struggling to come up with budget "offsets" to "pay-for" all of the health care provisions, especially new state Medicaid options. In order for this to occur, work incentive reform advocates must keep up the pressure on both Congress and the President to fully fund all of the needed expanded health care benefits to make this legislation an effective tool in helping people to get off the SSI and SSDI rolls and enter the workforce.
THE NEW HOUSE-PASSED VERSION OF HR 1180
As was noted in NAMI E-News Vol. 00-50 on October 15, the bill that the House Ways and Means Committee passed last week (HR 3070) made several important changes to the nearly identical bills that passed the Senate and the House Commerce Committee last summer by unanimous votes. Before sending the bill to the full House, Republican leaders inserted the text of HR 3070 into a new version of HR 1180 as a "substitute amendment" (the result being a new bill, with the old bill number).
However, in order to address concerns about the lack of "mandatory" spending for two Medicaid provisions in the bill, changes were made just hours before the House vote. Specifically, leaders on the House Commerce Committee agreed to impose a limit on eligibility up to 250% of the federal poverty level for the optional state Medicaid buy-in expansions. Under congressional budget scoring rules, this change allowed the bill's sponsors to apply the $91 million in "savings" toward making the two other Medicaid provisions - state infrastructure grants and a small portion of the demonstration program for working people who are not yet disabled - "mandatory," rather than "discretionary" funding (meaning that state participation in future years would not have to depend on congressional appropriations).
This 250% cap on eligibility is the same amount that states are already permitted to expand Medicaid under a provision for working people with disabilities under the 1997 Balanced Budget Act (BBA). After nearly two years, only a handful of states have elected to even seek this optional eligibility category. Eliminating this cap remains one of the key reforms in the Work Incentives Improvement Act. WIIA's sponsors in the House and the Senate have pledged to eliminate this restriction in the final bill, once additional financing provisions are found.
It is important to note that the confusing situation regarding the Medicaid sections of the House bill result mainly from the extreme difficulty in coming up with "offsetting pay-fors" that all sides can agree to. This is especially the case in trying to find "offset" savings in the Medicaid program that do not harm people with disabilities and other vulnerable groups. For example, school districts are opposing a change that would alter the way they seek reimbursement for health services provided to Medicaid eligible children in school-based clinics. As a result, this "offset" proposal is likely to undergo further revision and may end up being removed from the bill. These discussions are continuing between leaders in the House and Senate and the White House in an effort to complete action on the WIIA before Congress adjourns for the year in a few weeks.
The bottom line is that all sides are publicly supporting "mandatory" full funding of all of the Medicaid provisions in the bill - if the budget "offsets" that all sides agree on can be found. NAMI advocates are encouraged to continue to contact their members of Congress and President Clinton in order to urge all sides to redouble their efforts to find the budget savings needed to fully fund all of the health care (Medicare and Medicaid) provisions in the Senate bill (S 331). Beyond the struggle to maintain full "mandatory" funding of the Medicaid sections, it is expected that all of the other key provisions in the House and Senate versions of WIIA - the "ticket" program, continuing disability review (CDR) protections, expedited re-entry to cash benefits, the SSDI "2 for 1" sliding scale cash benefit demonstration - will be included in the final bill that is sent to the President.
Finally, it is worth noting that an important change was made in the House bill regarding one of the "offsets" affecting eligibility for SSI and SSDI cash benefits for prisoners. A provision in HR 1180 expands existing requirements Congress imposed on Social Security in 1996 to develop a new system for ensuring that inmates be removed from the SSDI rolls while they are in prison. These rules are further tightened in this bill. However, last week the House Ways and Means Committee added a protection that would exempt inmates eligible for SSDI serving sentences of 30 days and under. This change was intended to ensure that convictions for misdemeanors and minor felonies (all too common for many adults with severe mental illnesses) do not automatically result in loss of eligibility for cash assistance.
NAMI would like to recognize Representatives Rick Lazio (R-NY), John Dingell (D-MI), Henry Waxman (D-CA), Kenny Hulshof (R-MO), Robert Matsui (D-CA), Nancy Johnson (R-CT), Jim Ramstad (R-MN), Tom Bliley (R-VA), Mike Bilirakis (R-FL), Bill Archer (R-TX), E. Clay Shaw (R-FL), Charles Rangel (D-NY), Pete Stark (D-CA) and Ben Cardin (D-MD) for their strong leadership and effort to ensure the passage of meaningful work incentives legislation for people with disabilities, including people with severe mental illnesses. These champions of work incentives reform are already working with their Senate counterparts and the White House to ensure that this bill reaches the finish line before the end of the year.
SOCIAL SECURITY ADMINISTRATION ANNOUNCES 2.4% INCREASE IN BENEFITS FOR 2000
Social Security Commissioner Ken Apfel announced yesterday a 2.4% cost-of -living increase for Social Security, including SSI and SSDI, beneficiaries to take effect in January 2000. The Social Security cost of living adjustment (COLA) has been automatic since 1975 to protect beneficiaries from inflation and is based each year on the increase in the Consumer Price Index for Urban Wage Earners and Clerical Workers. Click on http://www.ssa.gov/pressoffice/2000cola.htm to see the Social Security press release.