Monday, January 28, 2013


Happy Friday all – well, Washington saw its first dusting of snow which followed the coldest air temps in two years.  The inaugural was spared the extremes as the clouds lifted after the president’s speech, and the sun began to shine.  Now the real work begins (again) as our elected officials try to get something done on the budget, gun control, and a host of other important subjects.  New cabinet members are being announced and confirmation hearings have begun.  Secretary Sebelius has announced that she plans to remain head of HHS so the health arena should remain steady-as-she-goes!

57th Presidential Inauguration.  Around 1 million people were in Washington to witness President Obama’s second inauguration, up significantly from the original estimates of 400,000 to 600,000.  The president outlined his vision for the next four years and beyond during his inaugural address.  The New York Times has this chart of VIPs up on stage with the president.

‘Profound & Devastating Blow.’  That’s how NIH Director Francis Collins describes the looming sequestration.  The Office of Management and Budget (OMB) has directed agencies to start preparing for the automatic cuts.  They are set to occur April 1st unless Congress takes action. 

Legal Ruling on Unlicensed Stem Cells.  A recent court ruling puts the breaks on use of unlicensed stem cells therapies for conditions, including MS, that many neurologists refer to as the ‘wild West’.

IRS Proposes new Health Regs for business.  Implementation of the Affordable Care Act isn’t only about what the Department of Health and Human Services does, it’s the IRS as well as it proposes new regulations for employer sponsored health plans.

That’ll be 10.3 miles please.  Any Big Mac meal lovers out there (other than me)?  Well, it’s a value meal item making it affordable but any idea how many miles it takes to burn off the calories of a Big Mac and medium fries?  You guessed it – 10.3 miles. 

Charitable Giving.  The ‘fiscal cliff’ deal of a few weeks ago preserved the charitable deduction and in fact, one study indicated that the slight tweak it was given may result in increased donations.  However, many in the non-profit world believe the threat has not passed, but rather, that we may all just be lying in wait for the next battle as the budget war continues.
Social Media Tips from HHS.  The agency has some ideas for effective use of hashtags for promoting health related issues.

Debt Ceiling, Default and Shutdown.  The House passed a 3 month lifting of the debt limit with added incentive that if they don’t get a deal done, Member of Congress will not get paid (I hear bi-partisan cheers throughout the country).  So while an official name of such a deal hasn’t surfaced, the subheader might fictionally read ‘The Congressional Paycheck Protection Act!  Senate Majority Leader Reid said he won’t oppose it and the White House indicated its support as well.  So this will temporarily stop the talk about  whether the United States will default on its $16 Trillion+ debt, whether the constitution enables the president to ignore the debt limit, then of course about how great an idea it is to shut down part or all of the federal government.  (Note – on the last issue, it didn’t work so well in the mid ‘90s for the party in power).

A Looming Thaw?  In a hopeful sign, Senate Minority Leader McConnell has extended a bit of an olive branch to the president, hoping to be able to work together to solve some of our nation’s largest challenges.

Best/Worst Congressional Bosses.  Interesting study about staff turnover in congressional offices.

Telemedicine Red-Tape.  Verizon’s EVP penned this opinion piece for Politico about how red-tape is tying up the advance of telemedicine.

Franklin’s Time Management.  No, not Franklin/Covey, Ben Franklin.  While he hasn’t uttered a word in centuries, his time management advice is probably more succinct now than ever.  The quote in this graphic is ‘By failing to prepare you are prepared to fail’ which is on-the-mark! 

Health Reform Implementation News:

  • gets a facelift: The Obama Administration’s comprehensive website about the Affordable Care Act has a new and improved look.  It seems the term “health insurance exchanges” is out, and  “marketplace” is in!  
  •  What’s your favorite metaphor? Maybe we should be describing health insurance exchanges more like Turbo Tax than Travelocity.   
  •  Really!?!  AZ Governor Jan Brewer’s support for Medicaid expansion in her state sure surprised a lot of people! Will other Medicaid expansion opponents follow suit?    
  •  Coverage Gaps on the Horizon?  Could people transitioning from Medicaid to Medicare in a reformed health care system experience gaps in coverage?   Our friends at the Medicare Rights Center recommend strategies for states and advocates to adopt to help make sure people don’t fall through the cracks unnecessarily. 
  • More proposed federal regulations (aka sleep aids).  The Public Policy Department is working in coalition with other disability groups to review and comment on  a  474-page proposed rule released last week.  As proposed,  state officials would be able to charge Medicaid patients higher cost-sharing for some services than current regulations allow. The proposed rule also affects a wide range of other Medicaid provisions, including appeals of eligibility determinations; coordination between Medicaid and the new health care law's insurance exchanges; the role of counselors to assist people with their coverage applications; procedures to verify employer-sponsored coverage; and the use of updated Medicaid eligibility categories. 
  •   Pre-Existing Condition Take-Aways.  So what lessons did we learn from the Pre-Existing Condition Insurance Program that could help ACA implementation? 

 See you after the Super Bowl!

Wednesday, January 23, 2013


On Monday, President Barack Obama was sworn in in front of the Capitol’s West Front and gave his second inaugural address. If you missed the address and would like to read it, please click here.

President Obama’s speech included references to programs important to people with disabilities--Medicare, Medicaid and Social Security. “The commitments we make to each other through Medicare and Medicaid and Social Security, these things do not sap our initiative. They strengthen us.” As Congress attempts to avoid scheduled across-the-board budget cuts (the “sequester”) and develop a comprehensive deficit reduction plan over the next several weeks, it is possible that changes could be made to these programs.

As the 113th Congress opens and a new presidential term begins, the Society will continue to urge that Medicare, Medicaid and Social Security remain strong for people with disabilities.

Thursday, January 17, 2013


With the Supreme Court’s June 2012 decision on the Affordable Care Act (ACA) making the Medicaid expansion optional, governors and state officials must make crucial decisions whether to participate in Medicaid’s expansion, affecting millions of Americans. There is no deadline for states to indicate they want to expand, but the next several months will be telling—with states running cost estimates to inform their decision. The earlier a state opts in to the Medicaid expansion, the more federal support they receive.

What does all this mean? Nuts and Bolts of Medicaid and the Medicaid Expansion:
  • Medicaid provides health coverage to nearly 9 million non-elderly individuals with disabilities, including people with multiple sclerosis (MS)
  • Medicaid is jointly financed by the state and federal governments
  • Currently, Medicaid is managed by each state and certain provisions, such as eligibility rules and services provided range widely from state to state
  •  The ACA included standardized and more generous (i.e., “expanded”) standards for Medicaid eligibility for lower income persons
  • However, the U.S. Supreme Court found the ACA’s Medicaid expansion to be unconstitutional as written. Seven Justices felt that forcing states to accept the ACA’s expansion in order to not lose the federal government’s share of Medicaid financing was coercive and a violation of the 'spending clause'

If all states expand their Medicaid programs, up to 21.3 million Americans, including people with MS could gain access to affordable, quality and comprehensive coverage.  Medicaid provides people with MS prescription drug coverage and standard medical benefits like physician and hospital care as well as home- and community-based services that allow people with MS to remain independent and other forms of long-term services and support.

So far, 18 states and the District of Columbia have announced that they will be participating in the ACA's opportunity to expand Medicaid.  As part of the National MS Society's Unified State Policy Agenda and in line with the Society's National Health Care Reform Principles, the Society urges all states to fully expand Medicaid so that all qualified have access to affordable, comprehensive health care.  For a list of states participating, please click here.  If your state is undecided or leaning towards participating, please contact your chapter to see how you can help advocate for Medicaid expansion in your state.

Monday, January 14, 2013


Happy (belated) New Year!  Since we last connected via Federal Fridays, the ‘fiscal cliff’ was averted, sequestration was delayed by two months, and many eyes are now focused on the debt ceiling limit which could be hit by mid-February.  In fact, the Washington Post reports that the U.S. will default in about five weeks.  Yeah, sorry, not all happiness and bliss in DC however at least everyone worked together to avoid the pending disaster. 

With health reform implementation again underway full-steam ahead, we are going to incorporate a separate section of Federal Fridays for Affordable Care Act implementation news at the end of each Federal Fridays.

Impact on Medical Research.  Research!America in partnership with Zogby released a poll showing that Americans are very concerned about the impact budget negotiations may have on medical research.  55% of respondents said that the U.S. isn’t putting enough into research.

$400 Million fund for Telemedicine.  The Federal Communications Commission (FCC) has created a $400 million ‘Healthcare Connect Fund’ to create and expand telemedicine networks and increase access to medical specialists.

Slowest Rate of Medical Spending.  The Hill reports on the HHS announcement that health spending only grew by 3.9%, matching 2009 and 2010.  The 3.9% is the lowest rate of growth in the 52 years the report has been issued.

How Charitable Giving Fares under Cliff deal.  According to a study by the Urban Institute, they project that charitable giving will actually increase because of the way things were structured in the law enacted by Congress to avoid the fiscal cliff . . . I guess only time will tell, but let’s hope!

Stem Cell Case Rejected by Supreme Court.  The U.S. Supreme Court this week rejected an effort to have a long-standing case brought before it.  The suit challenged the Obama Administration approach toward embryonic stem cell research and with this decision, looks like researchers have a green light to keep moving forward!

Corporation = Person so carry papers.  I know, confusing.  Federal law defines a person as a living breathing male or female, but corporation is also defined as being a person.  Well, one creative Californian decided to ‘carry his corporation’ on the passenger seat in his car therefore having two legal persons in the vehicle therefore qualifying to use the HOV lane.  Of course the police weren’t humored.  While this story is a bit humorous, it could have some real-life impact in terms of a possible redefinition of ‘person.’

Wanted:  Noisier Cars.  That’s right, the U.S. Department of Transportation wants electric cars to make more noise so that pedestrians can hear them.  I doubt the next-gen electric cars will roar like a Mustang GT or anything though.

American Dialect names words of the year.  In its 23rd annual words of the year vote, the American Dialect Society voted "hashtag" as the word of the year for 2012. Hashtag refers to the practice used on Twitter for marking topics or making commentary by means of a hash symbol (#) followed by a word or phrase. The award for the most euphemistic word of the year: "self-deportation: policy of encouraging illegal immigrants to return voluntarily to their home countries."

Cockroaches more popular than Congress.  A new Public Policy Polling survey finds that Congress only has a 9% favorability rating with 85% of voters viewing it unfavorably.  Colonoscopies, traffic jams and that NFL replacement ref all score higher than Congress in this survey. 
$1 Trillion Coin?  Yes, it is actually being considered and bantered about in DC.  Who needs a debt ceiling limit if you can just create more money via a trillion dollar platinum coin!?

Health Reform Implementation News:

  • More Changes Coming in 2013:  Here’s a nice summary of ACA provisions scheduled to kick-in this year.      

  • 18 + 2  + 4 = a lot less than 50.  The Center for Consumer Information & Insurance Oversight at CMS announced  “conditional approval” of  18 states’ plans to establish their own health insurance exchanges, plus two that plan to share responsibilities in a Federal Partnership Model.  Exchange plans, approval letters and more for these 20 states have been posted.  Only four other states had submitted applications as of January 3rd and it’s doubtful that many more applications will come in before the February 15th deadline. At this point it seems the majority of states will, by default, participate in the yet-to-be-established Federally Facilitated Exchange.   

  • Writing ‘the fine print’  Long-awaited proposed rules addressing many provisions of the ACA important to people with MS have been released in the past several weeks, including further definition of the essential health benefits, insurance “‘market reforms” and more.  The good folks at the Kaiser Family Foundation boiled down hundreds of pages of legalese from three of them into this 11 page brief.  
  • Medicaid Expansion Tracker:  The Center on Budget and Policy Priorities is trying to make it easy for us to keep track of states’ progress on Medicaid expansion with the (frequently updated)  map on the bottom of the first page of their report.   

  • Register now for January 30 webinar:  This one hour webinar on ‘Health Care Reform's Impact on People with Disabilities’ scheduled for January 30 at 2:00 EST looks like a good one.  Share this registration link with staff, volunteers, and/or clients that might be interested. 

  • 106 Accountable Care groups approved.  The U.S. Department of Health and Human Services this week approved 106 accountable care organizations/groups under the health law.

That’s it for now.  Remember, if you would like us to provide other types of information in this email, or you find articles of special interest, feel free to send an email with that info.