Children's Monitor Online
A Public Policy Update from the Child Welfare League of America

   
   
Vol. 18, Issue 35: 9/12/2005   
Headlines

CWLA Response to Hurricane Katrina

Key Republican Senators Urge Finance Entitlement Cuts Be Indefinitely Delayed

Leaders Allow Temporary Delay of Reconciliation Cuts

House Energy, Commerce Holds Hearing on Medicaid

House Education, Workforce Committee Delays Child Care Mark Up

McCrery Introduces Bill to Temporarily Extend TANF

Continuing Resolution Likely After October 1

Urban Institute Report on Medicaid and Foster Care Now Online

Budget Reconciliation Recap

Take Action On Reconciliation

Key Upcoming Dates for Congress



CWLA Response to Hurricane Katrina

CWLA sends its deepest heartfelt condolences to the victims of Hurricane Katrina. As the days pass, we are hearing more reports of loss of life and the thousands that have been displaced because of these catastrophic events. We also hear of the remarkable acts of heroism and the outpouring of concern for our friends in Louisiana, Mississippi, and Alabama.

CWLA member agencies are coming to the aid of others who were left without facilities, power, or food following Katrina. CWLA has established a Katrina Kids Fund that will directly assist those agencies that daily serve for the protection and care of the nation's most vulnerable children.

Take a moment and learn about some of these activities. Any donations you can provide will directly assist these child-serving agencies. For more information, visit www.cwla.org/katrina.

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Key Republican Senators Urge Finance Entitlement Cuts Be Indefinitely Delayed

While devastating the homes of thousands of people, Hurricane Katrina may have also changed the legislative agenda in Washington. As soon as Congress began its scheduled return on September 6, Senators Gordon Smith (R-OR), Olympia Snowe (R-ME), Jeff Bingaman (D-NM), and Blanch Lincoln (D-AR) sent a letter to Senate Finance Chair Charles Grassley (R-IA) urging an indefinite delay of the part of reconciliation that deals with entitlement cuts. The letter highlighted the effect of the hurricane, stating, "The need for help is immense…the government already has numerous programs available to help meet basic needs, including Medicaid, Food Stamps, housing, and education, Unfortunately, the reconciliation process as it stands would cut these programs."

The Senate Finance Committee has the most significant share of human service cuts, with its jurisdiction over Title IV-E Foster Care and Adoption Assistance, Medicaid, Medicare, TANF, SSBG, and Child Care. The committee has been directed to make cuts of more than $10 billion by September 16. The committee is closely divided, with 11 Republicans, 8 Democrats, and 1 Independent. When Independent Senator Jim Jeffords (VT) votes with Democrats, the Republican leadership needs to hold all Republicans. Both Smith and Snowe have made clear their displeasure with proposed cuts to Medicaid as the administration has envisioned. Smith led an effort last spring to reduce larger cuts in Medicaid sought by some members of both the House and Senate Budget Committees. He has favored a more deliberate approach to reforming Medicaid though a commission process.

While the four senators were urging abandoning entitlement cuts through reconciliation, similar sentiments were being expressed in the House. A letter by Representative Lois Capps (D-CA) had already garnered more than 100 signatures by Thursday morning. At the same time, during a House hearing on Medicaid, Representative Heather Wilson (R-NM) indicated her desire to stop the Medicaid cuts. (See "House Energy, Commerce Holds Hearing on Medicaid," below).

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Leaders Allow Temporary Delay of Reconciliation Cuts

In reaction to sentiments expressed by growing numbers of Senators and House members, the House and Senate leadership indicated it would put off consideration of reconciliation for approximately two weeks. At the same time, leaders indicated they were not abandoning the process or the cuts. There was concern that by delaying the cuts in programs and taxes, the legislation might loose the fast-track protection the reconciliation provides. House and Senate leaders indicated a delay would still allow for the package of program cuts, and a second package of tax cuts could still be adopted through the limited debate provisions reconciliation provides.

On September 7, Senate Budget Chair Judd Gregg (R-NH) indicated he intends to move forward with the two bills to cut programs and taxes and that the hurricane should not affect the two bills. Some have suggested a delay until the end of September. Although the current instructions require the committees to act on their budget and tax cuts by September 16 and September 23, respectively, there is no deadline for debating the bills on the floor. Even before Hurricane Katrina, the Senate was not expected to have time to debate a full reconciliation bill until October, due to that body's need to vote on a Supreme Court nomination and various appropriations bills.

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House Energy, Commerce Holds Hearing on Medicaid

With budget reconciliation instructions to save $14.7 billion, the House Energy and Commerce Committee held a hearing September 8 concerning the potential $10 billion cuts from Medicaid. Debate was split largely along party lines, with Democrats sharing the message that $10 billion should not be taken away from Medicaid on top of another tax cut package, especially in the wake of the thousands displaced by Hurricane Katrina.

Representative Heather Wilson (R-NM) broke with party leadership as she voiced her concerns that Medicaid deserves to be reformed in an effective manner, but not merely in the guise of a budget decision. Recognizing the full and lasting health and economic costs from the storm are impossible to accurately calculate, Brown said, Tthe last 10 days have changed everything." She urged Congressional leaders to postpone the entire budget reconciliation package, if not cancel it completely completely.

Committee Chair Joe Barton (R-TX) acknowledged that many survivors of Hurricane Katrina were Medicaid recipients but noted "the crisis of Medicaid is a manmade disaster" and Medicaid should be reformed to meet the demands of the 21st Century. Barton strongly urged committee members to consider the proposals recommended by the National Governors' Association when the committee’s final markup occurs in the next two weeks.

In the House, jurisdiction over Medicaid lies with the Energy and Commerce Committee; most of the rest of human service entitlement programs, including child welfare programs, come under Ways and Means. As many committee members are not aware of the vital role Medicaid plays in the complete financing of child welfare, CWLA provided testimony for the record that highlights the importance of Medicaid for the 800,000 children who enter foster care every year. The testimony also advised committee members of the dangers that could occur if Congress enacts the legislation sent by the White House and the Department of Health and Human Services. These proposals would greatly restrict the use of targeted case management and rehabilitative services and deny basic funding streams for operation. CWLA's testimony will be available on CWLA website soon.

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House Education, Workforce Committee Delays Child Care Mark Up

The House Education and Workforce Committee has delayed its hearing and vote on a child care reauthorization bill, originally scheduled for September 7. Although the child care bill is combined with a TANF reauthorization bill as part of the TANF-Child Care reauthorization debate, the hearing was billed as the committee's reconciliation hearing. Handling the child care reauthorization in this way suggests the House leadership intends to make the entire TANF and Child Care reauthorization a part of reconciliation legislation. Many advocacy groups have been concerned that Congress will pass the TANF-child care reauthorization bills in reconciliation to avoid a full debate in the Senate. If TANF and child care are reauthorized under reconciliation there would likely be little or no increases in child care funding, but there would be increases in the TANF work requirements. CWLA has opposed including TANF and child care in reconciliation and has suggested instead that Congress have a full debate on the reauthorization bills.

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McCrery Introduces Bill to Temporarily Extend TANF

Representative Jim McCrery (R-LA) introduced H.R. 3672 on September 7. The bill would provide a short-term extension of TANF through the end of December. It would also suspend work and penalty requirements for hurricane-affected states. Other members from states ravaged by the storm joined McCrery in cosponsoring the bill.

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Continuing Resolution Likely After October 1

The Senate began debate on the Commerce-Justice appropriations bill on September 8. With the new fiscal year beginning October 1, Congress has enacted only two appropriations bills, the appropriations for the legislative branch and appropriations for Interior and the Environment. This leaves 10 more bills to be dealt with, including the two biggest, defense and the appropriation bill for the Departments of Health and Human Services, Labor, and Education. House leadership has indicated it does not want to pass an omnibus bill that would roll all unfinished appropriation legislation into one. If the House follows that strategy, the only alternative would be to pass a continuing resolution, which would extend funding for a few weeks or months at levels equal to current fiscal year funding. How long a CR would run is unclear.

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Urban Institute Report on Medicaid and Foster Care Now Online

The Urban Institute report, Medicaid Spending on Foster Children, reported in the August 22 Children's Monitor is now on line at www.urban.org/url.cfm?ID=311221. The report highlights the importance of Medicaid in the child welfare system and shows that $3.8 billion was spent from Medicaid services for the child welfare community. Using fiscal year 2001 data from Medicaid, the new data shows that more than 869,000 youth in foster care received health services through Medicaid. The report also includes a state-by-state breakdown of Medicaid spending and the number of foster children enrolled in the health program.

Detailed in the report are the types of Medicaid services used by the child welfare community: rehabilitative services (13.1%), inpatient psychiatric (11%), inpatient hospital (9.4%), clinic services (8.7%), medication (7.7%), and targeted case management (7.1%). Also included are "other" services, at 16.7% of all Medicaid child welfare spending, which feature such options as eyeglasses, prosthetic devices, and other community-based waiver services. According to the report, nearly one-fifth of all children in foster care benefit from targeted case management, even though only 38 states report using TCM for the foster care population. Recipients enrolled in TCM have greater access to physicians, prescription drugs, dental care, and rehabilitative services than those children who are not covered by TCM.

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Budget Reconciliation Recap

The budget resolution adopted in the spring requires a reconciliation bill to be reported by specific committees by September 16. The resolution specifically calls on Congress to reduce federal spending on entitlement programs by $35 billion over five years. The resolution also calls for a second reconciliation bill to cut taxes by $70 billion. Committees have a deadline of September 23 for this legislation.

These deadlines have now been delayed, however. Congress is also expected to adopt additional tax cut provisions outside of the reconciliation process. Later in the year, Congress may pass a third reconciliation to raise the debt ceiling if the national debt reaches it legal limit before the end of this session of the 109th Congress.

The budget resolution adopted in the spring requires a reconciliation bill to be reported by specific committees by September 16. The resolution specifically calls on Congress to reduce federal spending on entitlement programs by $35 billion over five years. The resolution also calls for a second reconciliation bill to cut taxes by $70 billion. Committees have a deadline of September 23 for this legislation.

These deadlines have now been delayed, however. Congress is also expected to adopt additional tax cut provisions outside of the reconciliation process. Later in the year, Congress may pass a third reconciliation to raise the debt ceiling if the national debt reaches it legal limit before the end of this session of the 109th Congress.

Although Congress is not required to reduce federal supports for abused and neglected children through changes or cuts to Title IV-E Foster Care and Adoption Assistance or Medicaid to reach its budget-reduction goals, these programs are still under threat. The Administration has sent legislative language to Capitol Hill that would restrict the use of targeted case management and rehabilitative services for children in child welfare. Although the Medicaid Commission did not include these recommendations in its initial report to Congress, the White House is strongly encouraging Congress to include these changes. For specific details on how Congress may cut child welfare funding under Title IV-E and Medicaid, see the Children's Monitors for August.

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Take Action On Reconciliation

All members of Congress will have an opportunity to vote on the final budget reconciliation legislation. Members of the Senate Finance Committee and the House Ways and Means Committee are especially key, since those committee members are currently working to assemble recommendations by September 16 that will affect child welfare. Members of the Senate Finance Committee are listed online at http://finance.senate.gov/sitepages/committee.htm, and members of the House Ways and Means Committee at http://waysandmeans.house.gov. In the House, the Energy and Commerce Committee will make decisions on Medicaid changes and cuts. Members of Energy and Commerce Committee are listed at http://energycommerce.house.gov.

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Key Upcoming Dates for Congress

September 16 (tentative): Deadline for assigned committees to adopt $35 billion in cuts to mandatory programs for fudget reconciliation bill

September 23 (tentative): Deadline for tax-writing committees to adopt tax cuts of $70 billion

October 1: Start of federal fiscal year

Thanksgiving Holiday: Target adjournment date


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