Transcript The American Recovery & Reinvestment Act (Public Law 111-5) Hilary Dalin Associate Director, My Medicare Matters, National Council on Aging April 22, 2009

The American Recovery & Reinvestment Act
(Public Law 111-5)
Hilary Dalin
Associate Director, My Medicare
Matters, National Council on Aging
April 22, 2009
What Will We Cover?
•
•
•
•
•
•
Background on the legislation
Key provisions for your clients
Healthcare improvements included in legislation
Other important low-income provisions
Resources
Questions/comments
Background on the Legislation
• To help reverse the downward trend in national and local
economies, President Obama and Congress proposed a
stimulus bill to make investments in programs and
provide tax cuts to help stimulate economic growth.
• Leadership in both the House and Senate and relevant
committees worked on provisions to include in the
legislation.
Economic Stimulus Bill Works Its Way
through Congress
• The House drafted H.R. 1, the American Recovery and
Reinvestment Act, which passed by a vote of 244-188.
• The Senate then made some changes to the House
version, cutting some of the spending in the bill. The bill
ultimately passed by a vote of 61-37.
Economic Stimulus Bill Works Its Way
through Congress (cont.)
• Leadership in the House and Senate then convened a
conference committee to come up with a form of the bill
that both chambers could agree to.
• In the end, the final vote was:
– House: 246-183
– Senate: 60-38
• President Obama signed the legislation on February 17,
2009.
Economic Stimulus Bill Overview
• The final version of the economic stimulus bill
includes health related provisions, tax cuts,
appropriations and other provisions.
• Today we are going to focus mainly on the
provisions that most directly affect your clients,
plus other health related and low-income
provisions that may be of interest.
Key Provisions for Your Clients
Extension of Qualified Individual (QI)
Program
• The QI program is extended through Dec. 31,
2010.
• About QI:
– This Medicaid program pays Part B premiums
($96.40/month in 2009) for eligible Medicare
beneficiaries (those with incomes between 120-135
percent of poverty).
– People eligible for QI (and the other Medicare
Savings Programs) are also automatically eligible for
the Medicare Part D Low-Income Subsidy.
One-Time Payment
• $250 one-time payment going to almost
everyone who gets:
– Social Security,
– Supplemental Security Income (SSI), and/or
– Railroad Retirement Benefits, and Veterans, Disability
Compensation or Pension Benefits.
• As long as they received a benefit in November,
or December 2008 or January 2009
• Spouses each get a one-time payment
One-time Payment, cont.
• Some people will not get one-time payments:
– People who owe state or federal agencies money or are
delinquent in child support – money will be offset
– People not legally in US
– People living overseas
– People on SSI on Medicaid living in nursing homes or living in
some types of governmentally run facilities
– People denied benefits because they made false or misleading
statements
– People in prison or who violated parole or probation, plus fleeing
felons
– Kids getting Social Security
• But SSI kids do get a payment
One-time Payment (cont.)
• Will be received by first week in June 2009
• NO need to file a tax return or take any action
– SSA, VA and RRB making the payment automatically
• The one-time payment will be made separately from regular monthly
benefit payments.
– Payment method will be the same as for monthly benefit (direct deposit
or mailed check).
• Payment won’t count as income for purposes of determining
eligibility for or amount of any federal, state, or local benefit.
– As long as some federal funding supports the program
• Payments are not taxable income
– No tax return required in 2010 because of getting this one-time
payment.
One Time Payment – Poll
• Are you getting lots of questions from your
clients about the one-time payments?
– Yes a lot
– Not so many
– Nobody seems to know about the payment
• Take a look at a consumer-focused flyer
Any Questions?
• We’ll take your questions now about:
– QI extension
– One-time payments
• Remember to put your questions into the
question function
Healthcare Improvements Included in
Legislation
Premium Subsidies for COBRA Coverage
• Workers who were involuntarily terminated between
Sept. 1, 2008 and Dec. 31, 2009 are eligible for a
premium subsidy of 65 percent to pay for COBRA
coverage for themselves and their family for up to 9
months.
– The subsidy terminates if/when the worker is offered any
employer-sponsored health care or becomes eligible for
Medicare.
• To qualify, income in 2009 cannot be more than
$125,000 for a single person (or $250,000 for families).
• The subsidy is not counted as income when determining
eligibility for (or amount of) any federal, state or local
public benefit.
Federal Medicaid Assistance Percentage
(FMAP) Increase
• The rate at which the Federal government reimburses
states for Medicaid (FMAP) will be increased 6.2% for all
states for the period of Oct. 1, 2008 through Dec. 31,
2010.
– A total of $87 billion has been allocated for this effort.
• Additional funding will also be available for states based
on their unemployment rate.
– States with higher unemployment rates will receive even higher
payments.
FMAP Increase (cont.)
• Important notes:
– To qualify for funding, states are required to maintain eligibility
standards, methodologies and procedures that are not more
restrictive (under its State Plan or waiver) than those in place on
July 1, 2008.
– If states have restricted Medicaid eligibility recently, they can
only become eligible for the increased FMAP funds by
reinstating eligibility requirements that were in place on July 1,
2008.
Investment in Evidence-Based Programs
• $1 billion for a new Prevention and Wellness fund, to
invest in proven clinical preventive services and
community-based prevention programs.
– $300 million is allocated to the Centers for Disease Control
(CDC) immunization program, and
– $50 million is to be provided to states for “healthcare-associated
infections reduction strategies.”
– Remaining $650 million is directed to “evidence-based clinical
and community-based prevention strategies… that deliver
specific, measurable health outcomes that address chronic
disease rates.”
Funding for Health Information
Technology
• The Federal government will establish standards to allow
for the nationwide electronic exchange and use of health
information to improve quality and coordination of care.
– No later than 2010
• $19 billion is invested in health information technology
infrastructure and Medicare and Medicaid incentives to
encourage doctors, hospitals and other providers to use
health IT to electronically exchange patients’ health
information.
Other Healthcare Provisions
• $500 million to support programs which place health care providers
in underserved communities.
• $1.1 billion in comparative effectiveness research to provide patients
and providers with information about the merits of different
treatments
– Not to be used to establish cost or coverage criteria for Medicare or
Medicaid
• $2 billion for community health centers to provide for repairs and
renovations, allow them to invest in Health IT and provide critical
services.
• Transitional Medical Assistance (TMA) extended through Dec. 31,
2010.
– TMA provides Medicaid coverage to those people transitioning from
welfare to work. The bill provides a state option of a 12 month initial
eligibility period.
Any Questions?
• We’ll take tour questions now about:
– COBRA extension
– FMAP increases
– Evidence-based programs
– Health IT
– Other healthcare-related provisions
• Remember to put your questions into the
question function
Other Important Low-Income Provisions
Supplemental Nutrition Assistance
Program (SNAP, formerly the Federal
Food Stamp Program)
• $19.9 billion in additional funding for SNAP
– Will increase the benefit by 13.6 percent for recipients.
• The additional funding begins no later than mid-April
2009.
• The Secretary of Agriculture is required to establish a
simple process for states to notify households.
Senior Nutrition Programs
• The following programs will receive a total of $100
million in additional funding:
– $65 million for congregate meals,
– $32 million for home-delivered meals, and
– $3 million for Native American nutrition services.
• Funding is available immediately.
• No time period is required for expending the funds.
Community Service Block
Grants
• $10 million under Community Services
Block Grant to states and
– “shall be used for benefits enrollment
activities related to identification and
enrollment of eligible individuals and families
in Federal, State & local benefit programs”.
• Source: American Recovery and Reinvestment Act of 2009, H.R.
1(ARRA) Title VIII, DHSS, Administration for Families and
Children, Children and Families Services Programs, – page 65
Senior Employment
• SCSEP (Title V) will receive $120 million
– Could help create as many as 24,000 additional slots for lowincome older workers.
• The funding is required to be distributed to current state
and national grantees by mid-March and will be available
through June 30, 2010.
Extension of Unemployment Benefits
• Through 2009, up to 33 weeks of extended
unemployment benefits will be available to workers
exhausting their regular benefit.
• Through this time period, unemployment benefits will be
increased by $25 each week.
Social Security Disability Claims
• $500 million for processing disability and retirement
workloads, including information technology acquisitions
and research in support of such activities.
– Goal is to reduce the backlog of disability claims at Social
Security
• Funds are included to facilitate use of electronic medical
records for disability claims.
Digital TV Conversion
• $650 million is provided for the Digital-to-Analog
Converter Box Program.
• Most of the funding will be for additional coupons,
– $90 million is allocated for education, outreach and direct
assistance for “vulnerable populations, including senior citizens,
minority communities, people with disabilities, low-income
individuals, and people living in rural areas.”
Any Questions?
• We’ll take your questions now about:
– SNAP
– Senior Nutrition Programs
– Community Service Block Grants
– Senior Employment (Title V)
– Unemployment Benefits Extension
– SSDI Determinations
– Digital TV Transitions
Resources
• http://www.recovery.gov (Review how and when money is being
spent under the stimulus legislation)
• http://www.mymedicarecommunity.org/attachment.php?attachmentid
=277&stc=1&d=1239037166 (The text of the legislation)
• http://www.ncoa.org/userfiles/file/Stimulus_bill_summmary_FINAL.p
df (NCOA’s summary of selected provisions of the legislation)
• http://www.cbpp.org/1-22-09bud.htm (State-by-state estimates of
provisions affecting low and moderate income Americans)
• http://waysandmeans.house.gov/MoreInfo.asp?section=50.
Summary of legislation from House Ways & Means Committee.
• http://www.ssa.gov/payment (Read more about the one-time $250
payment to Social Security and SSI recipients.
• http://www.councilofnonprofits.org/stimulus (National Council of
Nonprofits Special Reports on Economic Stimulus and Recovery)
Questions/Comments?
Please contact:
Hilary Dalin
Associate Director, My Medicare Matters,
National Council on Aging
[email protected]