The Senate cut short their extended work schedule on Thursday when they finished work on several nominations including some from HHS.  They will be out until after Labor Day.  When Congress returns in September they will have a long list of items many that must be addressed by the end of the month or at least addressed with temporary fixes. There are only about 12 working days when both houses are in session before the end of September and the end of the fiscal year hits. Here is a listing of some of those items:

Debt Ceiling Increase:      Raising the debt ceiling could easily become the most dominant issue of September. There are early and quiet indications that the Republican Senate leadership would like to simply pass what is called a clean debt ceiling increase. That means no attachments, bills or proposals.  This is also the position of Secretary of the Treasury Steve Mnuchin.  He has been using tactics to stretch funding since late March when the ceiling was officially hit.  Mnuchin’s position may not be the official Administration position with Budget Director Mick Mulvaney saying he wants a deal on budget cuts as part of a ceiling increase.  It is also unclear where the President lands on the issue.

A clean debt ceiling increase may undercut Republicans support especially in the House of Representatives. Conservative Republicans are sure to demand cuts in programs especially entitlements as part of their agreement to provide the increase.

As a result, Republican leadership may have to rely on a significant number of Democrats to approve a debt ceiling increase. It is unclear what Democrats will ask in return. They could propose, as some have suggested, some form of guarantee that any tax package be revenue neutral as opposed to deficit neutral meaning programs could not get cut to pay for tax cuts. There are also other suggestions that they might bundle some inclusion of other programs such as a re-authorization of the CHIP-Children’s Health Insurance Program.

Home Visiting Extension:     Two House bills have been introduced to extend the Maternal Infant Early Childhood Home Visiting (MIECHV) program which runs out on September 30.  The Republican bill extends it for five years with some alterations and maintaining funding at the current $400 million a year.  The Democratic bill extends it for five year and increases it to $800 million by year five.  There are no Senate bills yet.  While there is bipartisan support for the home visiting program in the Senate it is unclear if there is support for a five year extension and with more funding.

The month of August offers an opportunity for CWLA members to show your support.  One way is to go to the CWLA ACTION CENTER and send a letter of support to your members of the House and Senate.

Send an e-mail to your member of Congress and senate Expressing your support for home visiting by going to the CWLA ACTION CENTER.

 

Next Steps in Health Care:     On the current status of the ACA, Washington is still waiting on the President and whether he will try and cut off the $7 to $10 billion in insurance subsidies to help stabilize markets.  While the President and some House leaders have called for another Senate attempt at repeal.  Majority Leader McConnell is ready to move on to tax cuts.

There appears to be some early signs that the Senate may engage in at least an initial effort to final bipartisan common ground on the ACA.  The Senate HELP Committee led by Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) have announced hearings in that committee to try and find bipartisan common ground on how to modify or strengthen the ACA. The leadership of the Senate Finance Committee has also raised this possibility.

How far they will get is an open question.  Alexander and Murray have succeeded in recent years at passing bipartisan packages that found some common ground, if not the funding, including the reauthorization of the Elementary and Secondary Education Act (ESEA or ESSA), the reauthorization of the Child Care and Development Block Grant (CCDBG) and an FDA bill.

CWLA will be advocating for a technical fix of the ACA provision that Medicaid coverage be available to age 26 for youth formerly in foster care.  The ACA mandated this coverage but due to the inability to adopt technical fixes to the ACA, this guarantee does not extend to a young person if s/he moves to a different state.

 Appropriations for FY 2018:     The House Appropriations Committee has adopted a Labor-HHS bill but the Senate has not yet acted. For more specifics, the CWLA Budget Chart can be viewed on the LEGISLATIVE INDEX.

There are some indications that the Senate may attempt to address a Labor-HHS bill the first week back and that they may attempt to do it on a bipartisan basis.  That always remains a challenge.

The House passed a “security measure.” The security measure includes the Defense Department, Military Construction, Veterans Affairs and the Legislative Branch budget. The House is assuming a $5 billion cut to non-defense discretionary spending below what was established under the Budget Control Act (BCA).  Non-defense spending is at $511 billion while the Defense Department is expected to get $621 billion.

The Senate Appropriations Committee has approved funding ceilings that will allow for $518 billion for non-defense spending and that is on par with the 2017 appropriations and slightly above the BCA.  The approval by Republican leadership sends a message that they are not in line with what the House is proposing.

Title IV-B and Child Welfare:     Child Welfare Services (Title IV-B part 1) and Promoting Safe and Stable Families (PSSF, Title IV-B part2) expired last year and they have a temporary extension through the end of this fiscal year.  At risk are some smaller programs attached to PSSF, the Court Improvement Program (CIP) and grants for drug treatment and workforce improvement. CWS receives an appropriation of $269 million and PSSF set at just under $400 million with approximately $335 million for the core services.

In June, the House of Representatives adopted a series of bipartisan child welfare bills. The five bills were all taken from last year’s Families First legislation that had been adopted by the House last summer. Taken together the bills would speed up placements across state lines, improve regional partnership substance use treatment grants and expand support for youth in or aging out of foster care. The bills went to the Senate where they are not likely (and in some cases, should not) pass individually but could easily pass as part of a larger package of legislation including a straight reauthorization of the two IV-B programs.

The Senate Finance Committee has this along with many other expiring programs including home visiting, CHIP, and several health care programs. 

Commission on Opioids:     On July 31, the Commission, Chaired by Governor Chris Christie (R-NJ) released an interim report of recommendations which can be found on the CWLA Legislative index under substance use.

The report is more of a summary with recommendations to be expanded upon.  Commissioners said, “In 2015, 27 million people reported current use of illegal drugs or abuse of prescription drugs…only 10 percent of the nearly 21 million citizens with a substance use disorder (SUD) receive any type of specialty treatment…

Overall the report offers proposals targeted more toward treatment than law enforcement measures which is a significant political turn from the law and order approach to crack-cocaine in the 1980s.

The full report is due in October but the report and issue may give an opening to child welfare advocates to highlight the need for greater access to substance use and mental health services—issues many members of Congress haven’t connected on yet.

Go visit your Member of Congress at the next town hall!  Families USA has a calendar that can tell you when your Member of Congress is back home and ready to hear your concerns.  View the town hall calendar here!

 

A possible shift to bipartisan fixes to the ACA, may be an opportunity to educate Members of Congress, especially members of various Senate and House child welfare-related caucuses that voting to cap and block grant Medicaid and by extension cuts to behavioral health services cannot be fixed with small-bore child welfare bills that mandate more services by states without the added resources.

Key recommendations by the commission include:

  • Rapidly increase treatment capacity…by waiver eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion;
  • Mandate prescriber education initiatives;
  • Fund a federal incentive to enhance access to Medication Assisted Treatment (MAT);
  • Model legislation for states to allow naloxone dispensing via standing orders; quickly develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies;
  • Enhance interstate data sharing among state-based prescription drug monitoring programs;
  • Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA);
  • Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool.

In addition, the report states that the commission is examining 11 other areas that will be more fully explained in the final report.

The Commission was established to develop final recommendations by October 1.  Other members include Governor Charlie Baker (R-MA), Governor Ray Cooper (D-NC), former-Congressman Patrick Kennedy (R-RI), Bertha Madras, Harvard Medical School.  Members also include the Secretaries of Health and Human Services, Defense and Attorney General.

Budget Battles Front and Center In September:     A House budget resolution reported from Committee has not been approved by the House.  The resolution would direct some $203 billion in entitlement and mandatory spending cuts. The House Ways and Means Committee would be directed to find $52 billion in cuts.  That means programs such as Supplemental Security Income (SSI), TANF, possibly child welfare services, and most certainly the Social Services Block Grant would all be targeted for cuts and in the case of SSBG total illumination.

For Congressional leaders, the prime need for this budget resolution is that it would create a reconciliation instruction that not only would direct the $200 billion in entitlement/mandatory cuts but would allow for massive tax cuts under the reconciliation/non-filibuster process.

Moderate Republicans have objected and there may be as many as 20 who will vote against the House budget resolution because it goes too far in cuts in both the annual appropriations levels as well as the cuts to mandatory/entitlement programs. On the other side of the philosophical divide are some conservative members who don’t feel it cuts enough in entitlement and mandatory programs and that seems to be a condition for the significant increases in defense spending.

It is unclear at this point what the Senate intends to do.  Both Houses want the tool of a new reconciliation instruction to fast-track tax cuts and there may be a way to do that and not deal with the other complexities of settling on spending levels and mandatory cuts.

Tax Cuts or Tax Reform:     Before the House departed at the end of July, the White House and Republicans in Congress released a joint statement on tax reform.  It was a general statement that filled in few details.

It discussed making taxes simpler, fairer, and lower for hard-working American families. One significant point was that they were dropping Speaker Paul Ryan’s desire to have a border tax.  The Senate left with mixed messages with Finance Committee Chair Orrin Hatch (R-UT) saying he wants a full committee and bipartisan process but Leader McConnell seemed to throw cold water on the idea saying that a Senate Democratic letter with 45 signatures meant they may be too far apart and reconciliation will be used again.

The Juvenile Justice and Delinquency Prevention Act Reauthorization (JJDPA):    Just before the Senate left last week, they gave a voice vote approval to a reauthorization of        S. 860, The Juvenile Justice & Delinquency Reauthorization Act of 2017.  That bill now joins H.R. 1809, the House version.

There are differences in the two bills with Senator Tom Cotton (R-AR) the main roadblock last year, winning some concessions on juvenile status offenders. Arkansas has a high percentage of incarcerated status offenders.

After the Senate sent the bill over, Congresswoman Virginia Foxx (R-NC), Chairwoman of the House Committee on Education and the Workforce, and Congressman Bobby Scott (D-VA), Ranking Member of the Committee issued a joint release saying:

“More than one million at-risk and vulnerable children are counting on Congress to make commonsense reforms to federal juvenile justice policy that will have a real impact on communities nationwide. The Senate’s action last night is another step closer to making those reforms a reality. The House has already shown its commitment to supporting at-risk and delinquent youth by passing bipartisan legislation earlier this year. The House bill provides opportunities to vulnerable youth, while also adding accountability and oversight to our juvenile justice system. We look forward to working with our Senate colleagues to craft a bipartisan, bicameral final bill focusing on evidence-based prevention efforts, alternatives to youth incarceration, public safety, and the just treatment of juvenile offenders as major priorities. Millions of young people are in need of an opportunity to have a successful life.”

The JJDPA was created in 1974 and it was last reauthorized in 2002 and is now nearly a decade overdue for reauthorization. The law remains the only federal statute that sets out national standards for the custody and care of youth in the juvenile justice system and provides direction and support for state juvenile justice system improvements. The House bill passed in May.

  1. 860 is sponsored Senator Charles Grassley (R-IA) and Senator Sheldon Whitehouse (D-RI).

Mandatory and Entitlement Cuts, SSBG Prime Target:     The House Budget resolution proposes $203 billion in cuts to mandatory and entitlement programs and some House members were pushing for closer to $500 billion.  There were a host of cuts in the President’s budget that come from cuts and the elimination of mandatory and entitlement spending. Both SSBG and TANF are targeted as major revenue raisers through the elimination of SSBG and a cut of $1.7 billion to TANF. Other key budget cutting targets are converting Medicaid to a block grant, cuts in the SNAP program, changes to the Pell grants and Supplemental Security Income/SSI program.

The protection of SSBG continues to be a top priority for CWLA and a host of state and local groups. An updated letter in support of SSBG now includes more than 80 national organizations and state and local groups from each of the 50 states.  State Fact Sheets on SSBG are on the Advocacy page on the SSBG State Fact Sheet Tab.

CHIP-Children’s Health Insurance Program:     Funding for CHIP is set to expire at the end of this fiscal year on September 30, 2017. CHIP was a Hatch-Kennedy bipartisan program created under the Clinton Administration and it has helped to extend funding to millions of children by provide states with grants to provide insurance coverage for children.  Combined with Medicaid, 45 million children receive health care coverage with CHIP covering nearly nine million of that total. In total, approximately 95 percent of children have health insurance coverage and CHIP has been a big part of that success. CHIP reauthorization is part of the CWLA legislative agenda for this year.

The legislation was last extended in 2015 and as was a concern back then, states are budgeting now for next year and it is important that they have the certainty of a CHIP reauthorization in planning those budgets.  If Congress fails to extend funding for CHIP, millions of children who rely on the program will face coverage disruptions or lose coverage altogether.  The Senate Finance Committee has announced hearings in that Committee when they return.

It should be near the top of the list of must do items.  Senator Orrin Hatch indicated that he was being pressed on attaching any number of must pass bills with the CHIP reauthorization.  This could play out in several ways being bundled under a debt deal, a home visiting deal or combined with undesirable cuts.

 Immigration: DACA, Refugees and Restrictions:     In June, Homeland Security announced what appeared to be an extension of the Deferred Action for Childhood Arrivals (DACA).  Later the Administration said they had not made a final decision on DACA but wanted to clarify their policy in another immigration area.

DACA allows an undocumented young person brought into the country at a young age to stay here if certain conditions are met. The original DACA order was issued by President Barack Obama in 2012.  More than 780,000 young people have applied for and are covered under the DACA rules.  This issue has been uncertain over the past year as candidate Trump had taken a position against continuation but the President has sounded a more sympathetic tone since January.  Where the Administration lands is uncertain.

Last month CWLA signed on to a joint letter in opposition of the Asylum Reform and Border Protection Act (H.R. 391). The asylum and refugee programs in the United States are designed to assist victims of persecution in other countries.  Generally, these are adults and children who are being persecuted on the grounds of race, religion, nationality political repression or due to being part of a certain group.  Many concerns have been raised about the punitive nature of the House bill.  There are also significant cuts in the budget to these same programs.

Other immigration issues include the boarder wall which threatens to upend appropriations as well as absorb several billion dollars.

Finally, there is the President’s endorsement of the Senator David Perdue (R-GA) and Senator Cotton bill, the Reforming American Immigration for Strong Economy Act (RAISE Act).  The legislation, which is already dividing Congress, threatens to cut legal immigration in half and threatens to deny access to millions who are currently eligible for entry under today’s law.

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