Monday, September 28, 2009

Action Needed: Call Your Senator

We received this bulletin from the National Association for Down syndrome (NADS)

Action Needed: Call Your Senator
If you have questions, please contact Susan Goodman at

Support Long-Term Services and Supports in Health Care Reform

Action Needed:
Call Your Senator with the following message:

Support long-term community support provisions in health care reform (Community First Choice Option and the CLASS Plan) in the Health Care Reform Bill.

Thank you for including provisions that prohibit pre-existing conditions provisions and lifetime caps on benefits that discriminate against individuals with disabilities.

You can use this toll-free number: 866-324-0787 which will connect you to the Capitol switchboard and ask for your Senator's office. The link to a directory can be found at the bottom of this e-mail.


Currently, the House of Representatives and the Senate are in various stages of development of health care reform bills. The House of Representatives currently has one bill it has developed that is still under consideration (HR 3200). The Senate Health Education Labor and Pensions committee (HELP) has a bill that has passed out of the committee. The Senate Finance committee, which is the major committee in the Senate with responsibility for the Senate bill, is considering a version which has been developed by a committee of six members (3 Democrats and 3 Republicans), but on which there is no agreement by the committee. If and when this bill passes the committee, it will be merged with the Senate HELP committee bill.

In all versions of a bill being circulated in the Senate, there are prohibitions against pre-existing condition clauses (clauses that deny eligibility based on Down syndrome and other disabilities) and elimination of lifetime caps on benefits. These are positive features of the now-circulated versions.

It is important for advocates to remember that the health care Congressional activity is in an almost constant state of flux, sometimes changing from hour to hour.

A major focus of NDSC's advocacy efforts have been the provision of long-term support services for individuals with disabilities. Virtually all long-term adult services are funded by Medicaid, the major health insurance program for adults with disabilities. Parts of this program are currently being considered during deliberations on the health care reform bills. You can read a side-by-side comparison of the current health care reform bills published by the Henry J. Kaiser Family Foundation at

Long Term Services


The CLASS Plan (Community Living Assistance Services and Supports - formerly called the CLASS Act) is a provision in the Senate HELP Committee bill that would create a national voluntary long-term care insurance program. It was developed to enable all people who are employed, even part time, to purchase an insurance policy for long term support needs. It will also help take pressure off of the Medicaid program which is now the primary source of funding for long-term adult support services. Unfortunately, the insurance industry has recently launched a full scale attack on the CLASS Plan (despite the fact that it will reduce the federal deficit). According to the American Council of Life Insurers, the CLASS Act will not adequately protect Americans who are in need of long-term care, citing the high costs of nursing home care and round-the-clock home health care services as evidence.

However, the CLASS Plan's cash benefit of about $27,000 per year (depending on functional needs) can go a long way to meeting the needs of people with disabilities by paying for support services in their own homes.

Community Choice Act

The Community Choice Act (CCA) would have required states to provide Medicaid community-based support services to all eligible individuals with disabilities (virtually all individuals with Down syndrome). The CCA would have had the effect of eliminating the state waiting lists for adult services (about 300,000 individuals in 2006). However, the CCA is not included in any version of the health care reform bills because of the high cost associated with it.

Community First Choice Option

The Community First Choice Option (CFC) was proposed by Senator Tom Harkin (D-IA), now Chair of the HELP Committee, as a way to get the key provisions of the Community Choice Act in the health care reform bill. The CFC Option would make it optional for states to offer individuals with disabilities the opportunity to receive support services in their homes and communities. The option would not allow caps on the number of individuals served, nor allow waiting lists. Significant enhanced federal matching funds (FMAP) would be provided, depending on cost, to encourage states to select this option. The CFC Option would be a major step in helping to end Medicaid's institutional bias.

The disability community is also working hard to get incentives for states to choose the CFC Option in health care reform bills, by increasing federal Medicaid matching payments that states receive for the Medicaid services it funds. Take Action

Call your Senator with the message found at the top of this Bulletin. To find the name of your Senator, go to and key in your zip code.

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