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Ambassadors Brief: November 2014

In This Issue:

FROM CHUCK’S CHAIR

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Dear National Council Ambassadors,

Election Day is over, and though not all the results are in, the GOP has gained control of the U.S. Senate, maintained control of the House and held on to the majority of governorships.

At the National Council, we have always dealt with both sides of the aisle on both sides of the Capitol.  We have strong supporters in the Republican leadership and equally avid advocates among top Democrats.  Our approach has always been bipartisan, because excellence in mental health and access to substance use services are not partisan issues.

We trust that, despite a continued divided government, our elected leaders will respond to your call for help to protect your clients and the communities you serve. With your help, we’ll be working to keep Congress focused on behavioral health and substance use services into the future.

Thanks, as always, for all you do.

Sincerely,

Chuck Ingoglia
Senior Vice President, Public Policy & Practice Improvement


UPCOMING ACTIVITIES

upcoming-activities-webJanuary 21, 2015: Ambassadors Network Quarterly Call

When:                  Wednesday, January 21, 2015, 3:00 PM EST
Where:                 Register online here 

Save the date in your calendars for the next quarterly call. We’ll give you a forecast of what to expect in the new Congress, provide an update on our legislative priorities, and more.


Ambassador Spotlight

peggy-terhune-smallCongratulations to this month’s outstanding Ambassador, Peggy Terhune!

Where:  Albemarle, North Carolina

What: Shared her personal and professional story

As CEO of Monarch NC, Peggy reached out to Rep. Renee Ellmers with a compelling and persuasive story about why Congress should expand Medicare to cover marriage and family therapists’ and mental health counselors’ services. She shared the impact it would have on Monarch’s ability to expand services and related the need for this policy change to her own life.

How you can do this too:

Stories are the key tool that help an issue stick in a policymaker’s mind – they lend heart and motivation to act! Share a story about one of your clients, staff, or yourself to stand out from the crowd and to make your request memorable.


DISPATCH FROM CAPITOL HILL

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If At First You Don’t Succeed…

If you tried something and failed 54 times, would you try again? After repeatedly failing to repeal the Affordable Care Act in the 113th Congress, ACA opponents are ready to try again in the new Congress come January. Campaign speeches aside, most politicians recognize that outright ACA repeal is both impossible and politically problematic without a replacement plan. But don’t expect the ACA to emerge from the 114th Congress unscathed. Here’s what’s ahead for everyone’s most loved/hated health care law.

Will Congress pass an ACA repeal bill?

Probably, but it won’t become law. After 54 failed attempts over the last two years, ACA repeal is sure to be high up on the new Congress’ agenda. Expect early introduction of a repeal bill, followed by committee hearings and floor votes. But even if ACA opponents can garner 60 votes to overcome a filibuster in the Senate, President Obama will certainly veto any “root and branch” repeal.

So the law is safe?

Not quite. Public dissatisfaction with the health reform law is high, even among many of the Americans who are benefitting from its coverage expansions. ACA opponents plan to use public sentiment to put pressure on the President to make piecemeal, but important, changes to the ACA. Some might even become law.

Give me some examples.

A bill to repeal the law’s medical device tax garnered strong bipartisan support in the current Congress. It’s also neither popular with the public nor a lynchpin of the law’s revenue reforms. That makes it low-hanging fruit. Another candidate for repeal or revision is the employer mandate, which has already been delayed twice by the Obama Administration. Congress could make changes to the definition of “full-time employee” (such as by increasing the threshold of workweek hours to 40 from the current 30) that would let employers off the hook for covering some of their employees. Congress might also act to abolish the controversial Independent Payment Advisory Board, which was envisioned as a means to control spending growth in Medicare but was never funded.

What will happen to the Medicaid expansion?

That decision rests primarily with the states, where so far, decisions to adopt the Medicaid expansion have not fallen strictly along party lines. Significant financial benefits are at stake for states that expand Medicaid. The Robert Wood Johnson Foundation estimates that for every $1 a state invests in Medicaid, $13.41 in federal funds will flow into the state. That funding is a powerful incentive that will only get stronger as some of the political controversies around the ACA subside in a Republican-led Congress that can take credit for eating away at its most unpopular provisions.

What should I say to my diehard partisan relatives when the topic comes up at Thanksgiving dinner?

That’s nice, dear. Our advice for maintaining family harmony is to stay away from politics and religion. But if you just can’t help telling off your tendentious uncle, point out that there’s politics, and then there’s policymaking. Massive laws like the ACA are always more complicated than the campaign stump speeches make them seem, and all members of Congress are going to have to find a way to deal with those complexities when the new session convenes in January. Stay tuned to Capitol Connector and the Ambassadors Brief for our latest news and insights.


STATE OF PLAY

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FY 2015 Appropriations. Chief appropriators Senator Barbara Mikulski (D-MD) and Rep. Hal Rogers (R-KY) are in talks to craft a fiscal year 2015 omnibus spending bill. Congress must take action on the 2015 budget before the current continuing resolution (CR) runs out on Dec. 11. While hurdles to passing an omnibus remain, congressional leaders appear to prefer this approach to a year-long extension of the CR.

Parity. A notice of proposed rulemaking (NPRM) on how parity applies to Medicaid is expected before the end of the year. Passed in 2008 and extended to cover new plans in 2010, the parity law applies to Medicaid managed care and Medicaid expansion plans, but the Obama Administration has not yet issued guidance on the specifics. New rulemaking will help clarify Medicaid’s obligations under parity.

Mental Health First Aid. The fate of Mental Health First Aid in the annual appropriations bill rests on how Congress decides to deal with FY 2015 spending. If Congress enacts a year-long extension of the current continuing resolution, Mental Health First Aid will continue to be funded at $15 million for school-based audiences. If they move an omnibus bill, advocates hope that new committee report language could expand the funding level and/or training audiences.

Excellence in Mental Health Act. SAMHSA held a listening session Nov. 12, allowing stakeholders to give input on how the Excellence Act certification criteria should be interpreted. CMS will hold a similar listening session on Nov. 20 to hear input on how the prospective payment system should be developed. There will be opportunities for written comment; stay tuned to communications from the National Council for template comments.


ADVICE AND COUNSEL

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Congratulations… Now, Can We Talk?

According to the most recent count, there are 11 newly-elected U.S. Senators, 58 soon-to-be freshman members of the House of Representatives, and 10 new Governors-Elect.  As these newly-elected legislators and executives begin to think about packing up and heading for the Capital, now is a great time to reach out to them to begin what we hope will be a productive relationship.

Included here is our Post-Election Toolkit: a set of materials to make it easy for you to reach out to these newly-elected individuals and invite them to tour your facility and/or sit down with you and your colleagues for a meeting.  We’ve included draft letters of invitations, a guide to developing a one-page fact sheet about your organization and even draft thank-you notes you can send following your meeting.

Now is always the best time to schedule a time to talk, to offer yourself, your organization and your expertise as a resource to help guide them through behavioral health.  Many will have very little – if any – familiarity with what you do, and this is an important chance to help shape their views on our issues!

National Council Post-Election Toolkit:

  • A draft letter of Welcome and Congratulations for newly elected senators and representatives. Send this letter to your legislator to introduce yourself and invite them to learn more about what you do.
  • A draft letter of Congratulations for re-elected legislators. Use this letter to reconnect with your legislator and invite them to visit your site to see your services in action.
  • A guide to creating a one-page fact sheet about your organization. A one-pager will show your legislators what your organization does and how it helps improve the lives of people in your community.
  • Draft thank you letters to legislators. Use this after they come to visit or hold a meeting with you.

BRIEFLY NOTED

briefly-noted-webHere are a few thought-provoking articles and resources that we’ve come across recently.  Happy reading!

New Members of the 114th Congress: Get to know your newly elected officials with the National Journal’s 114th Congress Almanac. See if you can spot the youngest-ever woman elected to the House and the new Rep who’s known for her taste in hats. Read more.

Prospects for Lame Duck: Congress must return to Washington to ensure the government can continue to operate beyond December 11 when the current continuing resolution expires.  But what else might they do? Read more.

McConnell and Boehner’s Goals for the 114th Congress: In January, Republicans will take control of the U.S. Senate, as well as shore up their majority in the House of Representatives. What will they do with their newly won power? Read more.