Posts Tagged ‘Senator Scott Brown’

Social Security Disability Income Under Fire From Budget Cutters

Wednesday, September 7th, 2011

Although some people are convinced that federal Supplemental Security Disability Income (SSDI) program for severely disabled children is a boondoggle, a four-year-old boy diagnosed with severe ADHD is an excellent example of how the program works.  The boy’s case workers said there wasn’t much they could do for him.  “We were at a standstill,” said the boy’s mother, who was barely scraping by as a single parent of two.  When doctors recommended she enroll her son in the SSDI program, her situation quickly improved.   A $674 monthly payment helps pay for her son’s day care, a private tutor and medications.  Most importantly, SSDI made the boy eligible for Medicaid, which provided access to the doctors he needed. 

“I can see a light in his eyes again,” according to the mother.  “He just looks so much happier.”  The SSDI program for children is expanding rapidly, with the largest increase among kids with mental, behavioral and learning disorders, including ADHD, speech delays, autism, and bipolar disorder.  

Even though the program benefits children in need, it is generating Congressional criticism.  The Boston Globe created a backlash that called the children’s SSDI program “The Other Welfare” and followed several families whose children’s eligibility for the program was open to discussion.  Several of the families believed that they had to medicate their children with psychotropic drugs in order to qualify for the benefit.  The series spurred Representative Geoff Davis, (R-KY), Representative Richard E. Neal, (D-MA), and Senator Scott Brown, (R-MA), to ask for an investigation by the Government Accountability Office (GAO), which is expected to be released by the end of the year.  In a letter to the GAO, the three lawmakers expressed concern about “recent reports in the media and elsewhere” that “have identified potentially alarming practices…(that raise) numerous concerns, including the potential for fraud and abuse in the program.”  Some Congressmen are not waiting for the GAO study results and have twice proposed limiting SSDI benefits.  The House budget resolution proposed that the government could save $1.4 billion over 10 years by reducing incentives in the SSDI program “for parents to place their children on medication solely to receive SSI benefits.”  

Advocates for children have rallied against the potential cuts.  The largest advocacy groups, including the Bazelon Center for Mental Health Law, the American Psychiatric Association, the American Academy of Pediatrics, and Children and Adults with Attention Deficit/Hyperactivity Disorder, have formed a coalition to protect the SSDI program for kids and are lobbying Congress.

 At present, SSDI provides cash assistance and Medicaid to the families of 1.2 million low-income kids who have severe disabilities, at a cost of $10 billion a year.  The program has grown by nearly 40 percent over the last nine years.  “Cutting the SSI program could have disastrous consequences for families, many of which already are struggling well below the poverty line,” according to Rebecca Vallas, a lawyer with Community Legal Services, a non-profit that is part of the coalition.  Vallas says the increase in the SSDI program is due to a national increase in child poverty and improved access to healthcare for kids, who get diagnosed earlier and more frequently with disabilities that might otherwise be ignored.

It’s not only kids who benefit from SSDI.   Recently, the Social Security Administration added 12 new conditions to its “compassionate allowances list,” including several heart ailments.  Applicants who have any of the 100 conditions  on the list are fast-tracked and can have a decision as quickly as two weeks.  For other people, the length of the disability process can be measured in months — or even years.  “When you have a catastrophic experience and you lose 50 percent of your income, it can mean that you’re selling your house, that you may not be able to support yourself. That’s so depressing for the patient,” said Karla Robeson.  Social Security is in the process of determining new conditions to add to the compassionate allowances list, though they’re getting more difficult to pinpoint, said Social Security Commissioner Michael Astrue.

Not everyone is supportive of the SSDI program.  Writing on Slate, James Ledbetter, a widely respected financial journalist, says that “They are the recipients of Social Security’s Disability Insurance, a somewhat obscure federal program that nonetheless eats up nearly $200 billion a year.  SSDI began in 1956 and was intended to provide benefits for people between 50 and 64 who’d been in the workforce but had developed ‘any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration.’  At the end of the first year, there were 150,000 Americans receiving SSDI benefits.  As Congress serially widened the eligibility criteria — by age, by type and duration of impairment — that number began to grow.  Enrollment hit one million adults in 1966; by the end of 1977 it was 2.8 million; and today it’s more than eight million ex-workers, plus another million disabled adult offspring and disabled widows and widowers.  SSDI represents, as the authors of a 2006 economics journal paper put it, a ‘fiscal crisis.’  Equally distressing, it also represents public policy run amok.  Over the last few decades, a program that was designed to help a relatively small group of people who were fatally sick or permanently unable to work has evolved into a backdoor welfare program in which a huge number of people are paid not to get jobs.  How huge?  Nationwide, we’re talking about well over four percent of the adult population.  In some states — Alabama, Arkansas, Kentucky, Maine, Mississippi, and West Virginia — the rate exceeds six percent.  These millions of workers extricated from payrolls represent untold billions in tax lost revenues and all manner of desperately needed economic activity (consumption, home purchases, etc.).”

Senate Republicans Refusing to Confirm Dr. Donald Berwick

Monday, March 14th, 2011

Senate Republicans are trying to block the nomination of Harvard-educated pediatrician Dr. Donald Berwick to serve a full term as the administrator of the Centers for Medicare and Medicaid Services.  Led by Senators Orrin Hatch (R-UT), the ranking member of the Senate Finance Committee, and Mike Enzi (R-WY), the ranking member of the Senate Health, Education, Labor and Pensions Committee, the senators contend that President Barack Obama’s recess appointment last year was completed before a hearing was held.  The senators contend that this hindered the 111th Congress’ ability to fully consider Berwick’s nomination.

“This abrupt and unilateral action meant that no senator — Democrat or Republican — was given the opportunity to ask Dr. Berwick a single question before he was placed in charge of an agency with a budget larger than the Department of Defense; which controls four percent of our nation’s gross domestic product; and, most importantly, directly impacts more than 100 million American lives every single day,” according to the Senators’ letter.  The senators say that Berwick’s “past record of controversial statements, and general lack of experience managing an organization as large as complex as CMS should disqualify him” from the post.  “Once you have withdrawn his nomination, we are confident we can all work together to find a nominee for administrator we can support and confirm after appropriate hearings are held,” the letter stated.

Even some Congressional Democrats are urging the Obama administration to find another Medicare chief after concluding that the Senate is unlikely to confirm Dr. Berwick. The most-favored nominee is Dr. Berwick’s principal deputy, Marilyn B. Tavenner, a nurse and former Virginia secretary of health and human resources who has extensive management experience and would likely be confirmed.  President Obama bypassed Congress and named Dr. Berwick to his post while the Senate was in recess last summer.  The current appointment allows him to serve to the end of 2011.

Despite the vocal opposition to Dr. Berwick, President Obama is refusing to withdraw his nomination. “The president nominated Don Berwick because he’s far and away the best person for the job, and he’s already doing stellar work at CMS: saving taxpayer dollars by cracking down on fraud, and implementing delivery system reforms that will save billions in excess costs and save millions of lives,” White House spokesman Reid Cherlin said.  Unfortunately for the president, even some Senate Democrats believe that Berwick cannot be confirmed.  Senate Finance Committee Chairman Max Baucus (D-MT) has said that he would not commit to a confirmation hearing, and other Democrats have acknowledged that the nomination is in trouble.  “I think it would be very tough in this environment.  If we can get some bipartisan products moving forward, then the answer is yes. If you can’t get some bipartisan products moving forward, it’s going to be difficult,” said Senator Ben Cardin, (D-MD).

The Medicare administrator’s job involved significant responsibilities under the healthcare law, such as establishing new insurance markets, expanding Medicaid, and overhauling the way Medicare pays providers to reward quality instead of volume. Republicans need 41 votes to block Berwick’s confirmation in the full Senate; their letter indicates they have more than enough.  The loss of Berwick, a respected medical innovator and patient advocate, would be a blow to the administration as it moves ahead in its implementation of the healthcare reform law.

Five Republican senators did not sign Hatch’s letter.  They are Scott Brown (R-MA), Susan Collins (R-ME),  Olympia Snowe (R-ME), Lisa Murkowski (R-AK), and Rob Portman (R-OH).

Obama Calls the States’ Bluff on Healthcare Law Implementation

Tuesday, March 8th, 2011

President Barack Obama is calling the states’ bluff on implementing the Patient Protection and Affordable Care Act (ACA) by allowing them to opt out of its most onerous requirements three years earlier than currently permitted. Speaking at a meeting of the National Governors Association, Obama specifically pointed to a proposal from Senators Ron Wyden (D-OR) and Scott Brown (R-MA) which he endorsed as a flexible approach.  “If you can come up with a better system for your state to provide coverage of the same quality and affordability as the Affordable Care Act, you can take that route instead,” Obama said, noting that, “If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does, without increasing the deficit, you can implement that plan and we’ll work with you to do it.”

The president endorsed the proposal to allow states to apply for “innovation waivers” beginning in 2014, three years earlier than originally scheduled. Under the terms of these waivers, states would be exempt from several of the law’s requirements if they set up their own method of adequately expanding coverage.  The “individual mandate” is the focus of multiple state lawsuits by states that contend it is unconstitutional.

The Obama administration has posted a detailed fact sheet on the proposal on the White House website. Additionally, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has blogged about it.

Despite lingering opposition to the healthcare reform law, the Obama administration is moving ahead with its implementation.  Over the last 10 months, HHS has made $2.8 billion available to states to help them start reforming their healthcare systems.  These funds let the states invest in improvements.  These investments are showing signs of progress thanks to more comprehensive oversight of insurance premium increases, new rights and protections for consumers, additional choices for people living with medical conditions, and the elimination of some of the worst insurance industry practices.

The bipartisan proposal’s future is uncertain, with both Democrats and Republicans casting wary eyes at it. Representative Eric Cantor (R-VA), the House majority leader, said the healthcare law is “an impediment to job growth” and that he is still committed to repealing the ACA.  “I was disappointed,” said Governor Rick Perry (R-TX) and chairman of the Republican Governors Association.  “Pretty much all he did was to reset the clock on what many of us consider a ticking time bomb that is absolutely going to crash our state budgets.  The states need more than that.”  Even some Democrats are cautious because they believe that it is impossible to expand healthcare coverage and reduce the deficit without the federal mandate.  Senator Max Baucus (D-MT) said “We want to give states as much flexibility as possible, but that flexibility shouldn’t fail to ensure that Americans in every state have access to quality, affordable healthcare.”

Writing in the Washington Monthly, Steve Benen asks “So, how big a deal is this?  It marks a fairly significant departure from the administration’s status quo, but at its root, what we’re seeing is the White House call Republicans’ bluff.  The GOP is convinced it can offer comparable coverage at comparable prices using Republican-friendly policies.  Today, in effect, the president said, ‘Be my guest.’  Why?  Because Obama knows it’ll take more than tort reform and HSAs to make the system work, and he sees a political upside to watching GOP officials scramble to actually craft their own plans, rather than bash his.”

President Obama also made it clear that the federal government is moving forward with healthcare reform. “I am not open to refighting the battles of the past two years or undoing the progress that we have made, but I am willing to work with anyone, governors or members of Congress, to make this law better…and fix what needs fixing,” Obama said.