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Independent Living News & Policy from the National Council on Independent Living

Action Alert: Urge Your Senators and Representative to Assist Medicaid-Dependent Home and Community-Based Providers

Senator Tammy Baldwin and Representative Ron Kind have agreed to send a letter to the United States Department of Health and Human Services (HHS) urging them to explore all solutions to assist Medicaid-dependent home and community-based providers in complying with the Affordable Care Act’s employer requirements.

People want to live in their community and not be forced into living in an institution. In order to do so, many people with disabilities require personal care and direct support assistance. Medicaid-dependent home and community-based providers (a term that includes many Centers for Independent Living) play a critical role in our healthcare system by providing long-term services and supports to people with disabilities.

It is urgent to take action now and ask your Representative and both of your Senators to sign on to the letter. Senators and Representatives who wish to sign on to the letter should contact Representative Kind or Senator Baldwin.

If we don’t act now to develop options for Medicaid-dependent providers, it could have devastating effects on the ability of people to get the services they need to stay out of institutions. Forcing these Medicaid-dependent agencies to abide by the Affordable Care Act would severely impact providers and force some to close their doors.

What You Can Do

It is urgent to invite House and Senate offices to sign-on to the letter. It is imperative that national groups and individuals contact their Congressional Representatives now!

By signing on to this letter, our Senators and Representatives can acknowledge the voice of consumers, which are urging HHS to reconsider the negative impacts that would be a result of this portion of the ACA.

Also, please let us know if your CIL or SILC would like to sign on in support. Should you have any questions, or wish to sign on to the letter, please contact Emily Rabin by email at emily@ncil.org or by phone at 262.818.3222. The deadline to sign-on is June 20th.

Thank you for your consideration. 

Sign On Letter

Dear Secretary Burwell,

We write to urge the Department of Health and Human Services (HHS) to consider the impact of the Affordable Care Act’s (ACA) employer responsibility requirements on Medicaid dependent home and community-based providers. These providers, which serve primarily Medicaid beneficiaries and operate on very slim margins, have raised unique concerns about complying with the ACA’s employer responsibility requirements. We share your commitment to implementing America’s new health law in a manner that works for both families and businesses, and request that you explore options to assist Medicaid dependent home and community-based providers in fulfilling the ACA’s employer requirements.

Medicaid dependent home and community-based providers play a critical role in our health care system by providing home health and long-term care to our most vulnerable citizens. These providers employ direct care workers who assist hundreds of thousands of people with their daily living needs such as getting out of bed, eating, and bathing, among other important services. Without access to these services, patients would be unable to live independently in their communities and would be forced to seek care in more costly institutional settings.

The challenging economic conditions and tight budget environment have placed significant strain on state Medicaid programs in recent years. As a result, provider payments have been cut or frozen across much of the country. This has had a significant impact on Medicaid dependent home and community-based providers, which already operate on small margins. As such, these providers struggle with providing employer health coverage for their direct care workers and caregiver employees, many of whom qualify for premiums tax credits or other assistance.

We are concerned that Medicaid dependent home and community-based providers could face significant financial burdens in complying with the employer responsibility requirements in the ACA. The penalty for failing to provide health coverage to full-time employees would disproportionately affect these providers and their direct care workers, which may result in unemployment and reduced patient access to essential services. We are encouraged by the Center for Medicare and Medicaid Services and the Department of Treasury’s engagement with these providers to date, and we urge you to continue to work with relevant stakeholders to find a viable solution to ensure that direct care workers can continue to provide vulnerable patients with home and community-based services under the ACA.

In light of recent decisions to provide for transition relief with respect to implementing requirements in the new law, we request that HHS fully explore options to support Medicaid dependent home and community-based providers in complying with the ACA’s employer responsibility requirements. Thank you for your attention to and timely consideration of this issue, and we look forward to receiving your response.

Sincerely,

Ron Kind, Member of Congress

Tammy Baldwin, United States Senator

Comments

  1. Linda L Halvorson says:

    I have had MS for 40 years and wish to remain in the handicapped accessible home we’ve built. The cost difference of my husband and I remaining here rather than in a nursing home is huge. It would take little assistance fron others to do this. Please sign on to this.

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