The Arc Responds to House Budget Committee Passage of FY 2019 
“Budget for a Brighter American Future”

Washington, DC, June 22, 2018 – This week, the House Budget Committee passed House Budget Committee Chairman Steve Womack’s 2019 Budget Resolution. 

Chairman Womack’s 2019 Budget Resolution would target health care programs including Medicaid, Medicare, and the Affordable Care Act (ACA), and substitute in a plan for the ACA that would cause 23 million Americans to lose health insurance by 2026, according to the Congressional Budget Office.  It also imposes severe reductions on non-defense discretionary spending, which funds programs like education, training, and employment that make community living possible for people with intellectual and developmental disabilities (I/DD).

 “The Arc strongly opposes the FY 2019 Budget for a Brighter American Future.  Like last year’s House Budget, this budget would have people with intellectual and developmental disabilities bear the brunt of the nation’s deficit reduction efforts. The cuts would slash trillions over a decade from essential programs serving people with disabilities. This budget not only widens economic inequality, it fails to address critical issues such as the growing need for long term supports and services resulting from our aging population. 

“We can read between the lines and see that the real purpose of this budget is to lay the foundation to cut Medicaid and other programs by the end of the year.  The Arc’s network of advocates united to block these cuts last year and we are ready to do so again if this budget resolution advances to the House floor and is introduced in the Senate,” said Peter Berns, CEO of The Arc. 

The Arc advocates for and serves people with intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 650 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

Why a Federal Balanced Budget Amendment is Bad for People with Disabilities

Almost everyone agrees that they should have balanced budgets, that is, that they should not spend more money than they take in. It makes perfect sense for individuals, so why not for our federal government?

Actually, there are several reasons why requiring a balanced budget for the federal government would be a very bad idea. For starters, let’s consider the assumption about individuals having balanced budgets.  If this were really the case, we would not be able to get home mortgages, student loans, or finance the purchase of a car. We would not be able to borrow money for such sound investments in our future.  

Requiring a balanced budget makes no more sense for the federal government than it does for individuals. The federal government needs the flexibility to do things like respond to natural disasters, public health epidemics, military threats, demographic changes, and economic downturns, among other things. What appears to be a commonsense approach is actually very bad public policy.

What is a Balanced Budget Amendment (BBA)?

Balanced Budget ScaleA balanced budget amendment is a proposed federal constitutional rule requiring that the government not spend more than its income in a given year. Most state constitutions have balanced-budget provisions and most of these make an exception for times of war or national emergency, or allow the legislature to suspend the rule by a supermajority vote. The U.S. Constitution does not require a balanced budget. Some members of Congress are looking to change that by passing legislation to add an amendment to the U.S. Constitution.

Why is a BBA Harmful?

It will result in cuts to Medicaid, Medicare, Social Security, and other large programs. Programs like Medicaid, Medicare, Supplemental Security Income (SSI), and Social Security are a large part of the federal budget. They are projected to grow in the next several years primarily due to the aging of the population. Since these are very popular and critical programs, Congress has been unable to make direct cuts to them and some Members are now looking to try less direct methods, including a BBA. 

Social Security and Medicare are particularly vulnerable to cuts because a BBA prohibits spending from exceeding revenues collected in that year. These programs operate with trust funds that collect dedicated payroll taxes designated for specific programs which are partially paid out in future years to meet projected population needs. For example, in years when Social Security collects more than it pays in benefits and other expenses (which it has done every year since 1984), the Treasury invests the surplus in interest-bearing Treasury bonds and other Treasury securities. These bonds can be redeemed whenever needed to pay benefits. The trust fund balances allow benefits to be paid when the Social Security program’s current income is insufficient by itself. Under a BBA, the $2.9 trillion in Treasury securities held in the Social Security Trust Fund would not be available to help pay benefits to the baby boomers for retirement or disability since almost all of it was collected in prior years.  

It would harm the economy.  A BBA would likely cause significant harm to the economy, making recessions both deeper and longer. In an economic slowdown, revenues (mostly taxes) fall while spending for unemployment and other benefits increases. A BBA would force policymakers to cut federal programs, raise taxes, or both when the economy is weak or already in recession, the exact opposite of what good economic policy would advise, according to the Center on Budget and Policy Priorities.

It is extremely hard to change.  An amendment to the Constitution is a dramatic step that takes a lot of time to enact. Unlike typical legislation, once a constitutional amendment has passed, it is extremely difficult to undo. 

What is Happening in Congress?

There are two BBA bills that have been introduced in the House of Representatives by Representative Bob Goodlatte (R-VA) – H.J. Res 1 and H.J. Res 2 – that Congress may vote on. While both versions are very harmful, H. J. Res 1 is the most drastic one since it essentially prohibits tax increases (by requiring a three-fifths vote in the House and the Senate) and limits spending to 20 percent of the economy (gross domestic product(GDP)). The House may vote on one of these bills as soon as next week.

Key Points for Advocates 

People with disabilities, their families, and advocates can:

  • Speak concretely about how their lives will be upended if the dramatic spending cuts forced by a BBA were to happen. What would happen if Medicaid, Social Security, and other programs were severely cut?
  • Call out the contrast – Question how Members of Congress can call for such drastic action to reduce deficits when they recently voted to add over $1 trillion over 10 years to the nation’s deficits in the tax law enacted on December 20, 2017.  See House votes here and Senate votes here.
  • Share what many leading economists believe – a BBA to the U.S. Constitution is very unsound economic policy. 

For more information, see:

The Arc on the ACA: “For People with Disabilities This is a Matter of Health, Independence, and So Much More”

Washington, DC –  As the U.S. Senate passed a budget resolution that begins the process of repealing the Affordable Care Act (ACA), The Arc released the following statement and background information on why the law is critical for people with intellectual and developmental disabilities (I/DD):

“Repealing the ACA without a replacement turns back the clock to a time when too many people with disabilities were discriminated against in the health insurance market. For those who were lucky enough to find affordable coverage, many were faced life and death care decisions because of arbitrary financial limits under those plans, or were stuck with service or support options that segregated them from the community.

“All people with disabilities need comprehensive, affordable care – the ACA took our country a giant step forward toward accomplishing this goal. The Arc has long supported expanding Medicaid coverage to adults and raising the income eligibility.  Due to those changes, millions of Americans, including people with disabilities, gained access to affordable, comprehensive health care.

“This is about people’s lives – their health, independence, financial stability, and so much more. The clock is ticking for millions of Americans, including people with disabilities,” said Peter Berns, CEO, The Arc.

The ACA made significant progress in expanding access to health care for individuals with I/DD. The ACA allowed states to extend their Medicaid programs to childless adults earning up to 138% of the federal poverty level. This change has provided coverage to individuals with I/DD and other disabilities and chronic health conditions who were not otherwise eligible for Medicaid, were in the waiting period for Medicare, or did not have access to employer sponsored health insurance because they were not working or working in low wage jobs without benefits.

  • The ACA provided federal money to support Medicaid expansion. The additional federal contribution to expanding Medicaid has helped many people with disabilities access health care.  It has also enabled states to continue and expand programs that provide supports and services to people with I/DD.
  • Several provisions of the ACA were designed to assist states to rebalance their long term supports systems, allowing more people with I/DD to receive the services and supports they need while living in the community instead of costly and outdated institutions. These include the Community First Choice Option (CFC) and the State Plan Home and Community-Based Services Option (also known as 1915(k) and 1915(i).
  • The ACA reversed years of discrimination against people with disabilities and chronic health conditions through its insurance reforms. Prior to the ACA, when people with disabilities or chronic health conditions tried to purchase health insurance in the individual market they often could not obtain coverage at all because of their pre-existing conditions; others faced sky high premiums, or were only granted very limited coverage.  

Learn more from The Arc’s ACA fact sheet, and sign up for our Disability Advocacy Network to know when to take action when it matters the most.

Social Security Announces 2015 Cost of Living Increase for Beneficiaries

Today the Social Security Administration (SSA) announced a 1.7 percent cost-of-living increase for 2015. This modest increase will help preserve the buying power of Social Security benefits for nearly 64 million Americans, including many people with intellectual and developmental disabilities who receive benefits under our nation’s Social Security system.

According to SSA, the average monthly Social Security retirement benefit will increase by $22, from $1,306 in 2014 to $1,328 in 2013. The average monthly benefit for a Social Security “disabled worker” beneficiary will increase by $19, from $1,146 in 2014 to $1,165 in 2015.

Higher Medicare premiums will offset some of this increase. Changes in Medicare premiums for 2015 are available at Medicare.gov.

Additionally, SSA today announced increases in important thresholds for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), including:

  • Substantial Gainful Activity (SGA) level – The SGA for SSDI and SSI will increase from $1,070 per month to $1,090 per month for non-blind beneficiaries, and from $1,800 per month to $1,820 per month for blind beneficiaries.
  • Trial Work Period (TWP) – The TWP for SSDI will increase from $770 per month to $780 per month.
  • SSI Federal Payment Standard – The SSI federal payment standard will increase for an individual from $721 per month to $733 per month, and for a couple from $1,082 per month to $1,100 per month.
  • SSI Student Earned Income Exclusion – The SSI student earned income exclusion monthly limit will increase from $1,750 to $1,780, and the exclusion’s annual limit will increase from $7,060 to $7,180.

Annual cost-of-living adjustments ensure that Social Security beneficiaries do not see their buying power eroded by inflation. SSDI and SSI benefits are modest, averaging only about $1,145 per month for SSDI beneficiaries in the “disabled worker” category and $535 per month for SSI beneficiaries. Every penny and every dollar counts for people who rely on these benefits to get by.

The Arc strongly supports ensuring adequate benefit levels, and has joined other national organizations to oppose proposals to reduce these much-needed annual cost-of living increases. Subscribe to The Arc’s Capitol Insider for updates to learn how you can help make sure that Social Security, SSI, and other vital supports are there for people with I/DD.

The Arc’s Statement on The Bipartisan Budget Act of 2013

The Arc released the following statement in response to Congressional leaders reaching a budget agreement negotiated by Senate Budget Chairman Patty Murray and House Budget Chairman Paul Ryan.  The Bipartisan Budget Act of 2013 would set discretionary spending for the current fiscal year at $1.012 trillion (about halfway between the Senate budget level of $1.058 trillion and the House budget level of $967 billion).

This agreement will help preserve programs that individuals with intellectual and developmental disabilities (I/DD) rely on, restore order to the federal budget and appropriations process, and reduce the deficit by between $20 and $23 billion. Additionally the agreement provides $63 billion in sequester relief over two years, that will be split equally between defense and non-defense programs, which will prevent further cuts to important programs.

“While The Arc is pleased that the budget agreement did not make major changes to our lifeline programs including Social Security, Medicaid, and Medicare, we are concerned about what appears to be the expansion of the state Medicaid agencies’ ability to recoup costs from settlements from Medicaid beneficiaries.  This could affect payments owed to individuals and families who have been harmed, received compensation, and depend on the compensation to pay for expenses beyond what Medicaid covers.  Allowing a state Medicaid agency to recover ‘any payments’ by a third party with legal liability (rather than just those payments for health care items and services, as under current law) would leave beneficiaries without coverage for other basic necessities,” said Peter V. Berns, CEO of The Arc.

The Arc Reacts to the U.S. Supreme Court’s Decision on the Affordable Care Act

Washington, DC – The Arc released the following statement in response to the U.S. Supreme Court’s decision to uphold the Affordable Care Act.

“People with intellectual and developmental disabilities have been waiting for generations for the insurance reforms put in place by the Affordable Care Act.  Today’s ruling removes any doubts that the law Congress enacted should stand and will benefit millions of people with and without disabilities.  It ends discriminatory insurance practices and makes health coverage more affordable and accessible – important protections which too many people with disabilities have been deprived of for too long.

“But the ruling is not perfect for people with I/DD.  The Arc is concerned that disallowing the federal government the ability to withhold Medicaid dollars from states that don’t expand their program to cover more of the uninsured might mean that people with I/DD who would have benefitted from the expansion could be left behind.  Medicaid is an incredibly important lifeline for people with I/DD, providing health care and long term services and supports.

“We will carefully watch how states react to this development and encourage our advocates across the country to put pressure on their state leaders to do the right thing and expand their Medicaid program,” said Marty Ford, Director of Public Policy for The Arc.

Top Reasons Why The Arc Supports the Affordable Care Act (ACA)

Health insurance Reforms in the ACA

  • Eliminates pre-existing condition exclusions
  • Bans annual and lifetime limits
  • Ends the practice of rescissions (insurance coverage is cancelled when a person develops a serious health condition)
  • Improves appeals process including independent reviews
  • Requires that 80% of health insurance premium dollars are paying for health care
  • Enhances state capacity to regulate unfair increases in insurance rates
  • Prohibits considering health status in calculating premiums (2014)
  • Requires guaranteed issue and renewals (2014)
  • Prohibits discrimination based on health status (2014)

The ACA Expanding Access to Coverage

  • Establishes temporary high risk pools to cover those who are currently uninsured (until 2014)
  • Allows coverage for dependents until age 26
  • Creates health insurance Exchanges for individuals and small employers to purchase insurance (2014)
  • Provides significant subsidies to assist low income individuals to purchase coverage in the Exchanges and provides tax credits to help small employers
  • Includes coverage of dental and vision care for children in the Exchanges
  • Includes mental health services, rehabilitative and habilitative services and devices, and other critical disability services in the health plans sold in the Exchanges

The ACA Expands Medicaid

  • Expands Medicaid eligibility to 138% of the federal poverty level
    • New method of income disregards
    • No asset test
  • 16 million new beneficiaries by 2019
  • Federal government pays 100% till 2016 (phase down to 90% in 2020)

The ACA and Long Term Services and Supports

  • Establishes the Community First Choice Option for states to cover comprehensive community attendant services under the state’s optional service plan
  • Improves existing Section 1915(i) option for home and community based services
  • Creates a new state balancing incentives to reduce institutional bias of Medicaid
  • Extends “Money Follows the Person” Demonstration
  • Authorizes the CLASS program

Other Medicaid and Medicare Improvements

  • Gives states the option to provide health homes for Medicaid enrollees with chronic conditions
  • Allows a free annual Medicare well visit with assessments and individualized prevention plan
  • Eliminates Medicare Part D (drug coverage) co-pays for dual eligibles receiving waiver services
  • Improves Medicare Part D access to key anti-seizure, anti-anxiety and anti-spasm medications

Selected Prevention, Provider Training, Data Collection and Accessibility Issues Addressed by the ACA

  • Eliminates co-pays for critical prevention services
  • Creates the Prevention and Public Health Fund (PPHF) to provide new funding for transformational investments in promoting wellness, preventing disease, and other public health priorities
  • Increases opportunities for training of health care providers (including dentists) on the needs of persons with developmental and other disabilities
  • Authorizes new training programs for direct support workers who provide long term services and supports
  • Improves data collection on where people with disabilities access health services and where accessible facilities can be found
  • Adds disability as a category to measure health disparities and in health care quality reporting surveys
  • Requires the establishment of criteria for accessible medical diagnostic equipment

Key disability Data Regarding Access to Health Care

According to the Centers on Medicare and Medicaid Services (CMS)

15% of the uninsured have at least one disability (HHS/ASPE Analysis of 2010 CPS self-reported data)

12% of uninsured adults with incomes below 138% of the federal poverty level report limited ability to work or unable to work (Urban Institute Analysis of 2006 MEPS data)

Altman, B. Bernstein A. Disability and health in the United States, 2001-2005.  Hyattsville, MD National Center for Health Statistics 2008

  • Adults 18-64 with cognitive difficulty, 13.6 % had no insurance, 32.1% private insurance, 41.0% Medicaid, and 27.0% Medicare.
  • Adults 18-64 with disabilities are less likely than those without disabilities to have private health insurance coverage – 46.3% for those with complex activity limitation and 61.3% with basic actions difficulty (61.3%) compared to 75.2% with no disability.

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Children with Special Health Care Needs in Context: A Portrait of States and the Nation 2007.  Rockville, MD: U.S. Department of Health and Human Services 2011.

  • Children with special health care needs – 29. 4% had inadequate coverage compared to 22.1% of children without special health care needs. Inadequate insurance is a far more prevalent problem than gaps in insurance or lack of insurance among children with special health care needs. (29.4% inadequate insurance whereas 12.3% had gaps in insurance or no insurance).
  • Children with special health care needs have unmet needs for specialty medical care—27% had problems accessing specialists and of the children with emotional, behavioral or developmental conditions, 48.4% did not receive mental health services.

Children with special health care needs are defined in the National Survey of Children’s Health as those who have one or more chronic physical, developmental, behavioral or emotional conditions for which they require an above routine type or amount of health and related services.   14-19% of children in the U.S. meet this need.

Reaction from The Arc on The Super Committee Not Reaching a Deal

Washington, DC – As the nation’s largest organization working on behalf of people with intellectual and developmental disabilities (I/DD), The Arc’s CEO Peter V. Berns released the following statement on today’s announcement that Members of the Joint Select Committee on Deficit Reduction have not reached a deal to reduce the nation’s deficit by at least $1.2 trillion over 10 years.

“Throughout the Committee’s process, The Arc advocated for protecting Medicaid, Medicare and Social Security because the budget cannot be balanced on the backs of people with disabilities. It is disappointing that the Committee could not come to an agreement that would have protected these critical programs while ensuring significant revenues were part of the solution. Unfortunately, no deal at the moment leaves lots of unknowns for the rest of the programs on which people with disabilities rely on to live independent lives.

“The Arc believes we must strengthen the economy while protecting the lifelines of people with disabilities, and to honor that commitment, bring in sufficient revenues to provide necessary services. We appreciate Members of Congress who stood their ground and opposed deep cuts to Medicaid, Medicare and Social Security.

“We recognize that this was a missed opportunity, when Members of Congress could have worked across party lines and found a solution to a deficit and revenue problem facing us all – young and old, people with disabilities and without, wealthy and poor. It will take a true bipartisan effort to ensure a secure future for people with disabilities, the elderly, and low income people. Individuals with disabilities, their families, and the professionals who support them will continue to monitor the budget process and advocate for their lifeline.”

The Arc Commends the U.S. Senate for Voting Down Disastrous Budget for People with Disabilities

WASHINGTON – Late yesterday, the U.S. Senate voted down a federal spending plan that could have disastrous consequences for people with intellectual and developmental disabilities (I/DD).  Leading up to the vote, The Arc, the nation’s largest and oldest human services organization for the I/DD community serving more than a million people with I/DD individuals and their families, opposed this legislation because it would cut $750 billion over 10 years out of Medicaid and end the program as a guaranteed benefit by turning it into a “block grant” that leaves cash-strapped states to fill in the funding gaps with very little oversight.

“The U.S. Senate’s vote put the brakes on a disastrous budget proposal for people with intellectual and developmental disabilities.  As Congress and the nation continue to debate how to promote economic recovery and tackle our deficit, it can’t be done on the backs of people with intellectual and developmental disabilities,” said Peter Berns, CEO of The Arc.

The House of Representatives passed this budget plan, known as the Ryan Plan after its author, Congressman Paul Ryan of Wisconsin, in April. The bill includes drastic cuts and changes to:

  • Medicaid: Cuts $750 billion over 10 years and ends Medicaid as a guaranteed benefit by turning it into a “block grant” that leaves cash-strapped states to fill in the funding gaps with very little oversight.
  • Medicare: Replaces Medicare with a voucher program for younger beneficiaries that will certainly provide less than the current system.
  • Discretionary Programs: Eliminates, over time, most federal government programs outside of health care, Social Security, and defense as the cuts are so deep.
  • Health Care Reform: Repeals and defunds the Affordable Care Act.

The $4.3 trillion from all of these cuts would be used to provide $4.2 trillion in tax cuts over 10 years without tackling the nation’s deficit.

For people with I/DD, these cuts would have a huge impact on their health and lives. People with I/DD could be denied health insurance coverage, home and community based services, supportive housing, job training, education, transportation, and other services. Medicaid currently funds 78% of services for individuals with I/DD.

President Obama Provides Clear Alternative on the Budget

Preserving Safety Net for Most Vulnerable, Not Tax Breaks for Millionaires

WASHINGTON, D.C. – The Arc’s Chief Executive Officer Peter V. Berns issued the following statement in response to President Obama’s George Washington University address:

“President Obama today reaffirmed his commitment to reducing the federal deficit while holding true to our most cherished American values.  We believe that the President’s plan to preserve our vital safety net programs – Medicare, Medicaid, and Social Security – is more balanced and fair than the plan advanced by the House Budget Committee. Instead of relying on cuts to vital programs for the most vulnerable Americans, the President is proposing to raise revenues by ending the unfair tax advantages enjoyed by the richest individuals and corporations in America and balancing the spending cuts.”

“We take heart in hearing the President’s frequent mention of people with disabilities in his speech.  This shows that he understands that the over 7 million Americans with intellectual and developmental disabilities will be among those most harmed by the House Budget plan to block grant Medicaid, end Medicare as we know it, repeal the Affordable Care Act, and decimate funding for housing, education, transportation and employment programs by making deep cuts over time. We appreciate the President’s call to stand for the rights of people with disabilities.”