January 26, 2006

Dear Representative:

We are writing as members of the Consortium for Citizens with Disabilities (CCD). We strongly urge you to OPPOSE the budget reconciliation conference report because of the serious harm it would cause the 9.4 million children and adults with disabilities and others who rely on Medicaid for essential health and long-term services and SSI and TANF for critical income support. Unlike the Senate-passed budget reconciliation package, the conference report achieves budget savings in ways that would weaken critical Medicaid protections upon which people with disabilities and other low-income beneficiaries rely. Indeed, while we also opposed the House-passed budget bill, the conference report is significantly worse than even that regressive bill.

Harmful provisions include:

• The home- and community-based services provisions are worse than the status quo. They weaken the current coverage guarantee extended to more than 722,000 individuals in the 31 states with the personal care option and hundreds of thousands of individuals in the 47 states with the rehabilitation services option by permitting enrollment caps and waiting lists in a new state plan option—the very policies that currently prevent Medicaid waiver programs from meeting the needs of all people with disabilities otherwise eligible for community services.
• Cost-sharing provisions that will only lead to necessary services being denied and effectively punishing people with disabilities who have extensive health and long-term services needs. This includes no limits whatsoever on premiums and co-payments that most individuals below the poverty level can be charged.
• Changes to the EPSDT requirement that will only lead to a more bifurcated system that will impose formidable barriers for children in Medicaid trying to access the full range of covered services.
• Asset transfer policies that go beyond the consensus reforms in the Senate bill and that will make it harder for some seniors with disabilities to qualify for Medicaid—even if they do not have substantial incomes or were not purposefully divesting assets to qualify for Medicaid.
• TANF reauthorization that toughens work participation rates, subjects state maintenance of effort dollars to federal TANF work requirements, and develops a standardized set of approved work activities without ensuring states have the flexibility to meet the needs of families that include a person with a disability. The TANF provisions increase the risk that these vulnerable families will lose the services and supports they need.
• A delay in the payment of back benefits owed to beneficiaries of Supplemental Security Income (SSI) which saves about $1 billion from people who can least afford it.

While we are supportive of the Family Opportunity Act and the Money Follows the Person demonstration, these provisions alone do not justify supporting a Medicaid and TANF reform package that is excessively harmful to people with disabilities.

Sincerely,
American Academy of Pediatrics
American Association on Mental Retardation
American Association of Health and Disability
American Association of People with Disabilities
American Congress of Community Supports and Employment Services
American Counseling Association
American Foundation for the Blind
American Dance Therapy Association
American Network of Community Options and Resources
American Therapeutic Recreation Association
Association of Assistive Technology Act Programs
Association of University Centers on Disabilities
Bazelon Center for Mental Health Law
Center on Disability Issues & the Health Professions
CHADD (Children & Adults with Attention Deficit/Hyperactivity Disorder)
Council for Exceptional Children
Council of Parent Attorneys and Advocates
Council of State Administrators of Vocational Rehabilitation
Easter Seals
Epilepsy Foundation
LDA, Learning Disabilities Association of America
National Alliance on Mental Illness
National Association for the Advancement of Orthotics and Prosthetics
National Association of Councils on Developmental Disabilities
National Association of Private Special Education Centers
National Association of Social Workers
National Association of School Psychologists
National Association of State Directors of Special Education
National Disability Rights Network
National Down Syndrome Congress
National Fragile X Foundation
National Mental Health Association
National Organization of Social Security Claimants’ Representatives
National Rehabilitation Association
National Respite Coalition
National Spinal Cord Injury Association
National Structured Settlements Trade Association
NISH
Research Institute for Independent Living
The Arc of the United States
Title II Community AIDS National Network
Tourette Syndrome Association
United Cerebral Palsy
United Spinal Association
World Institute on Disability