Washington Update

Deep federal spending cuts averted — for now

Scott Barstow, Art Terrazzas & Jessica Eagle February 1, 2013

Hours after the start of the new year, Congress and President Obama agreed to a package of tax cuts, tax increases and spending changes to avert the major policy changes scheduled to take place under previous law. The Senate passed the package — the American Taxpayer Relief Act (H.R. 8) — by a vote of 89-9, and the House of Representatives followed suit with a vote of 257-167. Both chambers passed the bill Jan. 1.

Under the legislation, the tax increases scheduled to take effect at the beginning of the year were removed for most Americans. Tax rates for individuals making more than $400,000 and couples making more than $450,000 went up 4.96 percent. The measure makes permanent the tax cuts for households making less than those amounts.

The measure also postpones for two months the major spending reductions that had been scheduled for Jan. 2. School counselors and educators remain in a holding pattern regarding what to expect in terms of spending, however. Congress has yet to decide on funding levels for education programs for the second half of federal Fiscal Year 2013, extending from the end of March through the end of September. The 113th Congress, which began its term Jan. 3, was faced with immediately having to begin hammering out either a broader deficit reduction agreement, including both spending cuts and tax increases, or another short-term measure to allow time for more negotiation. Because of the budgetary discussions being postponed for two more months, we are unlikely to see the new Congress tackle laws such as the Elementary and Secondary Education Act, the Carl D. Perkins Vocational and Technical Education Act, and the Individuals with Disabilities Education Act. These major education laws fund and support school counselors and their students, and each of these laws is long overdue for reauthorization.

H.R. 8 postpones for one year the 27 percent reduction in physician payment rates that was scheduled to take effect at the beginning of January. The Congressional Budget Office estimated this postponement to cost $25.2 billion over the next 10 years. The 113th Congress will remain under pressure to somehow address this issue in 2013 without the underlying payment formula being changed. This will provide us with another potential vehicle for attaching legislative language to establish Medicare coverage of counselors.

HHS proposes rule for essential health benefits

On Nov. 26, the Department of Health and Human Services (HHS) issued a proposed rule regarding the “essential health benefits” that health plans will be required to offer through state insurance exchanges beginning in 2014. The Affordable Care Act stipulates that health plans must cover 10 categories of health benefits, including “mental health and substance use disorder services, including behavioral health treatment.” In the proposed rule, HHS would require health plans to provide these services in a manner consistent with the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). Although HHS needs to issue more regulations to fully implement MHPAEA, it was important that the parity requirements were linked with the essential health benefits requirements under the Affordable Care Act.

The American Counseling Association submitted comments on the essential health benefits regulations, expressing strong support for requiring plans to adhere to MHPAEA requirements in providing essential health benefits. ACA also expressed support for the proposed rule’s provisions regarding existing state-mandated health benefits. In the rule, HHS requires states to defray the costs of providing state-required benefits that go beyond the essential health benefits package. However, HHS is proposing that states not be required to defray costs associated with abiding by state laws related to provider types — such as requiring coverage of services provided by counselors. State counselor coverage laws should be viewed as upholding patient access to care, not as establishing benefits different from those required under the Affordable Care Act.

New Congress offers new opportunities for advocacy

January marked the beginning of the 113th Congress, meaning new senators and representatives from across the country were sworn in and began their work. Although many members of Congress were re-elected, quite a few new faces are serving in Washington for the first time.

In light of this recent turnover, we are encouraging ACA members to visit the offices of their federal lawmakers as they begin this new session. You can find out who your senators are by visiting senate.gov and who your congressmen and congresswomen are by visiting house.gov.

Please take some time to visit their official websites and sign up for their e-newsletters, Twitter accounts and other social media outlets. You can then be notified about events near you where you might get the opportunity to talk to your elected officials about counseling issues. We encourage ACA members to stay in touch with their legislators in Washington so these public officials will know about the needs of counselors and their clients, as well as the wonderful work that counselors do in their communities.

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