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Separate court proceedings in California and Louisiana last week upheld the right of elders and people with disabilities to receive care in their homes under the Americans with Disabilities Act (ADA).

In California, federal judge Claudia Wilken issued a preliminary injunction on Jan. 19 blocking the state from enacting a 20 percent cut to the In-Home Supportive Services (IHSS) program, which provides care to nearly 450,000 elders and people with disabilities who have Medicaid.

The cuts were initially scheduled to take place on Jan. 1, but were temporarily halted by Wilken last December due to concerns that they violated the ADA. Wilken reiterated those concerns in her latest injunction.

If ever enacted, the IHSS budget cut would cause 372,000 IHSS consumers to see reductions in home care services, possibly forcing them into nursing homes or other institutions — a violation of the ADA. In 1999, the Supreme Court ruled that the ADA gives seniors and people with disabilities the right to live at home if their care needs can be reasonably met there.

“Judge Wilken has consistently recognized how crucial IHSS is for people with disabilities in California,” said Donna Calame, the executive director of the San Francisco IHSS Public Authority and a PHI board member.

“Her ruling was terrific for both technical legal reasons and because it continues, for the time being, the current level of service hours to people who live in borderline poverty situations — both consumers and the workers who assist them,” Calame added.

The state plans to appeal Wilken’s decision to the Ninth Circuit Court of Appeals. Last month the Ninth Circuit ruled that Washington State had violated the ADA by cutting its Medicaid in-home care program by 10 percent.

Louisiana Lawsuit Settled

Meanwhile, in Louisiana, advocates for elders and people with disabilities reached a settlement with the state over a reduction in-home care services there.

Advocacy Center and AARP Foundation Litigation advocates had filed a class action lawsuit in September 2010, arguing that the state was violating the ADA by imposing a 32-hour weekly cap on consumers enrolled in the state’s Medicaid in-home services program.

As part of the settlement (pdf), state officials will request 200 waivers from the federal government allowing Louisiana residents who receive Medicaid to qualify for long-term personal care services.

The waivers will be awarded to consumers who can demonstrate that the 32-hour cap would force them to transfer into a nursing home.

Ken Zeller, a senior AARP attorney, told the Associated Press that the settlement is “win-win” because it “allows people to age in the place they know and love and at the same time saves the state money in more costly nursing home placements.”

– by Matthew Ozga

The Joint Committee on Deficit Reduction — better known as the “Super Committee” — has only until November 23 to report out a deal to find $1.2 trillion in savings over the next ten years or face a “trigger” that would result in automatic cuts.

It is looking less and less likely that a deal can be struck, according to news reports.

If a deal can be reached, this would be the second installment of deficit reduction measures, following the cuts made by Congress earlier this year.

Areas that the committee is likely considering include:

• revenue increases, including raising taxes and reforming the tax code to eliminate tax breaks and loopholes;
• military spending cuts; and
• measures to reform and slow the growth of entitlement programs, including Medicare, Medicaid, and Social Security.

Divided Over Cuts to Safety-Net Programs or Raising Taxes for the Wealthy

The Committee, made up of six Democrats and six Republicans, is divided over the balance between cuts to core safety-net programs for low- and middle-income Americans and tax increases for the very wealthy.

On November 15, Representative Jeb Hensarling, the Republican committee co-chair, said he and his colleagues had “gone as far as we feel we can go” on taxes, and that “any penny of increased static revenue is a step in the wrong direction.”

If the super committee fails, Hensarling said that Republicans will look to undo the compromises they have already made.

Automatic Trigger Would Devastate Key Government Programs

Should the automatic “trigger” go into effect, half of these cuts are scheduled to come from domestic spending (excluding Social Security, Medicaid, and a few other programs that help the poor). The other half is scheduled to come from the Pentagon. Neither party wants to see defense budget cuts of that scale, which is intended to be an incentive to reach a deal.

Sen. Bernie Sanders (I-VT) speaks at rally to support jobs and to protect Medicare, Medicaid, and Social Security

Though discussed less often, the 7.8 percent across-the-board cuts to domestic spending would be devastating to key government programs, such as homeland security, law enforcement, environmental protection, food safety, and transportation infrastructure.

The committee is considering various proposals, from a $4 trillion “grand bargain” that would match significant tax increases on the wealthy with significant cuts to programs such as Medicare and Medicaid, to smaller packages that would not require new revenues. Given the looming deadline, more proposals are expected over the next few days.

Advocates Turn Up the Heat

Advocates are turning up the heat to push the super committee to not agree to any cuts in Medicare, Medicaid, and Social Security.

For example, the American Health Care Association and the Alliance for Quality Nursing Home Care have launched a Care Not Cuts effort to fight cuts in programs. A wide range of labor and consumer organizations, including Caring Across Generations, are holding rallies in Washington, DC and across the country on November 17 to support jobs, not cuts.

For more information on how Medicaid cuts would affect beneficiaries and threaten millions of health care jobs, read PHI’s Medicaid Matters…in Super Committee Deficit Reduction Deliberations (pdf).

– by Carol Regan, PHI Government Affairs Director

Nearly 200 national organizations, including PHI, ran a newspaper ad in key Congressional districts urging readers to urge their Congress members not to cut Medicaid-funded long-term services.

Cutting Medicaid-funded long-term care services would deny millions of older Americans and people with disabilities “the choice to receive the services they need to live independently in their homes and communities,” the ad explains.

The Medicaid cuts could also lead to the loss of “thousands of direct-care jobs, putting a greater burden on individuals and families.”

The ad, paid for by AARP, ran primarily on October 31 and November 1 in newspapers including the Arizona Republic, Lansing State Journal, Annapolis Capital Gazette, Olympian, Columbus Dispatch, Nevada Appeal, Boston Globe, and Helena Independent Record.

The congressional “Super Committee,” tasked with proposing $1.5 trillion in federal budget cuts by November 23, is considering deep cuts to the Medicaid program (pdf).

– by Deane Beebe

On September 21, hundreds of individuals with disabilities, families, direct-care workers, older adults, and others whose livelihoods depend on Medicaid gathered on the West lawn of the U.S. Capitol to rally against cuts to Medicaid.

They chanted “My Medicaid Matters,” drawing curious staff and lawmakers out onto Capitol balconies.

Rally speakers included advocates, Medicaid beneficiaries, direct-care workers, and six members of Congress. They emphasized that Medicaid is important for independence, health, families, and direct-care jobs.

The rally’s target was the Joint Select Committee on Deficit Reduction (pdf), or the “Super Committee,” which was created by the Budget Control Act enacted in August. The committee is tasked with finding at least $1.5 trillion in additional federal deficit reduction through spending cuts or revenue increases by November 23.

Earlier this week, President Obama released his proposal for deficit reduction (1.5 MB pdf), which includes $72 billion in cuts to Medicaid, as well as tax changes estimated to raise $1.5 trillion in revenue over 10 years.

Speaking at the rally, Senators Tom Harkin (D-IA) and Bernie Sanders (I-VT) and Representatives Danny Davis (D-IL), Dennis Kucinich (D-OH), Christopher Murphy (D-CT), and Jan Schakowsky (D-IL) applauded rally-goers for their dedication to defending Medicaid.

Each of the lawmakers voiced their support for protecting Medicaid from cuts and stressed the need to raise revenue as part of the solution for reducing the deficit.

The rally was sponsored by 84 national organizations working on behalf of people with disabilities, older adults, and direct-care workers, including PHI.

PHI National Policy Analyst Gail MacInnes attended the event. “It was inspiring seeing such a diversity of organizations and individuals all unite to defend a government program that has done so much to support millions of American families,” she said.

– by the PHI Policy team

On Wednesday, September 21, thousands of advocates are expected to converge on Capitol Hill to rally in support of the Medicaid program.

Nearly 60 organizations, including PHI, are sponsoring the event to let Congress know that Medicaid:

• supports long-term care costs for adults and children with disabilities;
• funds millions of direct-care jobs; and
• pays for vital services that allow elders to remain in their homes and communities.

The congressional “Super Committee” is tasked with proposing $1.5 trillion in federal budget cuts and will likely focus on Medicaid.

PHI’s new fact sheet, “Medicaid Matters…in Super Committee Deficit Reduction Deliberations,” (pdf), explains why Medicaid is at risk.

For more information on the “My Medicaid Matters” rally, visit the website of ADAPT, a disability-rights advocate and a rally sponsor.

– by Deane Beebe

A congressional “super committee” tasked with slashing $1.5 trillion from the federal budget will likely propose deep cuts to Medicaid, according to the newest PHI “Medicaid Matters” fact sheet.

“Medicaid Matters…in Super Committee Deficit Reduction Deliberations” (pdf) explains why Medicaid will prove to be a particularly vulnerable target to the super committee, which met today for the first time.

The PHI Medicaid fact sheet also urges advocates to call or write members of the super committee or their own members of Congress to let them know how important Medicaid is to seniors, people with disabilities, and direct-care workers, and to urge them to protect it from devastating cuts.

Formation of Super Committee

Last month’s Budget Control Act — the last-minute deal that authorized a raise in the federal debt ceiling — called for the formation of a bipartisan committee of 12 senators and representatives, charged with devising a way to cut the federal deficit by $1.5 trillion over the next 10 years.

The committee has until November 23 to submit its proposed cuts; Congress must vote on its proposal by December 23.

The so-called super committee is chaired by Sen. Patty Murray (D, WA) and Rep. Jeb Hensarling (R, TX). A full list of committee members can be found in the PHI “Medicaid Matters” fact sheet.

Medicaid in the Crosshairs

“Medicaid Matters…in Super Committee Deficit Reduction Deliberations” lists numerous reasons why Medicaid funding is especially at risk, even when compared to other middle-class economic-security programs such as Social Security and Medicare.

For example, the sheer size of Medicaid will make it a target for both Democratic and Republican super committee members, the report notes.

Additionally, Republican committee members have already publicly promoted a weakening of Medicaid. In April, all three of the super committee’s Republican representatives voted for an FY12 House budget resolution that would diminish Medicaid’s federal funding by converting it to a block grant.

Pushing Back Against Medicaid Cuts

Medicaid is a critical program for everyone in America because it:

• Pays for the majority (62 percent) of costs related to long-term care services and supports
• Funds millions of direct-care jobs, fueling the nation’s economy
• Will be responsible for the coverage of millions of currently uninsured Americans — including 365,000 direct-care workers — under the terms of the Affordable Care Act

Advocates have already begun to mobilize to prevent the super committee from slashing Medicaid.

The disability-rights organization ADAPT will host a rally on Capitol Hill on September 21, joined by members from approximately 40 other disability, aging, and civil rights groups.

– by Matthew Ozga