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Infrastructure Negotiations Continue in Fits and Starts

National Council of NonProfits

The release of the President’s budget proposals did not divert attention away from the main policy action in Washington: bipartisan negotiations between Republican Senators and the White House over significant legislation to fund infrastructure and other projects and programs over the next five to eight years. The results of these negotiations are of great importance to charitable nonprofits for two reasons: first, the substantive details in any legislative package, and second, whether policymakers take the bipartisan path or the partisan path on the President’s top agenda item will determine which, if any, of the nonprofit policy priorities can be attached and enacted this year. Further, how any infrastructure bill will be financed could affect other nonprofit priorities.

In late March, President Biden offered the $2.2 trillion American Jobs Plan as his initial set of infrastructure proposals. A group of Republican Senators countered with a $568 billion package dealing only with roads, bridges, waterways, and broadband – items they consider “true” infrastructure matters. The White House then released a $1.7 billion counteroffer that the Republicans rejected and put forth their counteroffer last week. Called the Republican Roadmap, the Senators upped their proposal to $928 billion in spending on infrastructure, about $250 billion of that amount deemed new spending (above what’s already expected by extending current law). The plan one-pager claims, “This counteroffer delivers on much of what President Biden provided in his feedback to us during our Oval Office meeting while still focusing on core infrastructure investments.”

Paying for It: Regardless of what the two sides agree to spend, the answer to how to pay for it could create significant challenges. Politico summarized the standoff this way: “The White House has suggested paying for the package by increasing the corporate tax rate, a non-starter for the GOP. Republicans have instead suggested user fees and using unused money allocated for coronavirus relief, arguing that there is a precedent for doing so. Democrats have rejected those suggestions.” In a separate memo to the President, the Senators suggest partially paying for the legislation by tapping unspent federal relief funds sent to the states. That latter proposal – reclaiming or “clawing back” monies approved in the American Rescue Plan Act – is strongly opposed by state and local governments, and by nonprofits.

 

Exclusive: U.S. to give ransomware hacks similar priority as terrorism

Christopher Bing www.reuters.com  

The U.S. Department of Justice is elevating investigations of ransomware attacks to a similar priority as terrorism in the wake of the Colonial Pipeline hack and mounting damage caused by cyber criminals, a senior department official told Reuters.

Internal guidance sent [last] Thursday to U.S. attorney's offices across the country said information about ransomware investigations in the field should be centrally coordinated with a recently created task force in Washington...

Last month, a cyber criminal group that the U.S. authorities said operates from Russia, penetrated the pipeline operator on the U.S. East Coast, locking its systems and demanding a ransom. The hack caused a shutdown lasting several days, led to a spike in gas prices, panic buying and localized fuel shortages in the southeast. read more

Colonial Pipeline decided to pay the hackers who invaded their systems nearly $5 million to regain access, the company said.

The DOJ guidance specifically refers to Colonial as an example of the "growing threat that ransomware and digital extortion pose to the nation."

"To ensure we can make necessary connections across national and global cases and investigations, and to allow us to develop a comprehensive picture of the national and economic security threats we face, we must enhance and centralize our internal tracking," said the guidance seen by Reuters and previously unreported.

Read Full Article

 

What will home care look like post-COVID-19? Brooks-LaSure will help guide us

McKnight’s Senior Living
Liza Berger 
 
It is not a coincidence that two symbolic healthcare policy events took place [last] week.
 
I’m talking about the Senate’s confirmation of Chiquita Brooks-LaSure as administrator of the Centers for Medicare & Medicaid Services and the introduction of H.R. 3447, the Permanency for Audio-Only Telehealth Act. The latter would allow for Medicare coverage of audio-only telehealth services after the COVID-19 public health emergency.
 
Brooks-LaSure is stepping into CMS at a time when Congress and regulators are making key decisions about healthcare in the post-pandemic world. She will help lead home care and other providers through this major period of transition.
 
Among those big decisions are how to handle telehealth, which perhaps literally and figuratively saved lives during the period of lockdown. Just last week the House introduced H.R. 3371, the Home Health Emergency Access to Telehealth Act (HEAT), which would provide reimbursement for telehealth services in the Medicare Home Health benefit during an emergency period.
 
Brooks-LaSure also will preside over an agency that will be navigating the likely growth of hospital-at-home, a major CMS initiative that, like telehealth, flourished thanks to the pandemic. There is no question that pressure is building on lawmakers to extend the Hospitals Without Walls program, as the executive director of Moving Health Home told McKnight’s Home Care Daily this week.
 
Of course, other issues hang in the balance. These include a possible expansion of Medicaid home- and community-based services, the growth of the Home Health Value-Based Purchasing Model, and the possibility of Medicare-covered skilled nursing facility-level care at home. Legislation regarding the latter may be introduced in the coming days.
 
Welcome aboard, Chiquita. You should have more than enough to keep you busy.  

 

AARP Makes Strong Statements re: Future of HCBS

During a roundtable on long-term care last Wednesday (June 2), AARP leaders advocated for expanding long-term care ate home and improving home caregivers’ qualify of life.

Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond stated, “The home is the new health care center. Make no mistake about it. People are not anxious to go to nursing homes -- they want to stay in their homes.”

The organization advocated for a legislative push on, “home-focused long-term care policy,” indicating that the toll on nursing homes exposed the inadequacy of America’s long-term care system, though they recognized that many problems predate COVID-19.

LeaMond declared that in addition to Biden’s HCBS proposal, AARP supports other policies that support home care workers, including family caregivers, like the Credits for Caregivers Act. The pending legislation would provide federal tax credits for people who provide long-term care to family members.

As reported by Inside Health Policy, "Susan Reinhard, senior vice president and director of the AARP Public Policy Institute said that states should be trying to speed up Medicaid eligibility determinations for people who end up in nursing homes after hospital stays. This could avoid unwanted nursing home stays by making people eligible for HCBS benefits sooner. Some states have already begun using presumptive eligibility models."
 

Top Democrats jump-start push to offer a health care 'public option,' a Biden promise

NBC News
 
Rep. Frank Pallone and Sen. Patty Murray are trying to craft a government-provided insurance option to compete with private plans and extend coverage.
 
May 26, 2021, 9:45 AM EDT
 
WASHINGTON — Two Democratic committee chairs overseeing health care policy are seeking to jump-start a legislative push to craft a "public option" to compete with private insurers.
 
House Energy and Commerce Chair Frank Pallone, D-N.J., and Senate Health, Education, Labor and Pensions Chair Patty Murray, D-Wash., wrote a letter to interested parties on Wednesday seeking their input by July 31 on how to structure a government-provided plan.
 
"We believe bold steps are necessary in order to achieve universal coverage and lower health care costs," the chairs write. "Health care affordability remains a challenge for many American families despite the fact that the United States spends more on health care than any other country."
 
Pallone and Murray touted the Affordable Care Act's successes at extending coverage but noted that "tens of millions of American still remain uninsured or underinsured."
 
A "public option" was one of President Joe Biden's campaign promises, billed as a moderate alternative to rival Bernie Sanders' plan to scrap private coverage and put all Americans in Medicare. But Biden has not included the policy in his economic rescue and stimulus proposals so far, instead seeking to infuse cash in the ACA exchanges and invest in Covid-19 vaccines.
 
But the Democrats are signaling it is still a priority, and aim to introduce a bill by the end of this year, a Murray aide said.
 
It will be a daunting task for Democrats, who have paper-thin margins in Congress and not much hope of winning Republican support. They are likely to face an assault from health industry groups, including insurers who won't want to compete with the government, as well as doctors and hospitals who would complain about likely reductions in reimbursement rates.
 
In their letter, Murray and Pallone requested information that would help them on the design and scope of the legislation, including whether the federal public option should be made available to all individuals or more targeted.
 
And in a statement, they cited a recent Morning Consult/Politico poll that shows 68 percent of Americans favor a public option, "where people can choose from a government-run health program or private insurance."

Recently, Democrats have offered competing bills for a public option, which was considered in the 2010 Affordable Care Act legislation and dropped after some party defections.
 
Sen. Michael Bennet, D-Colo., and Sen. Tim Kaine, D-Va., introduced the Medicare-X Choice Act, which would set up a Medicare-style public option. And Sen. Sheldon Whitehouse, D-R.I., and Sherrod Brown, D-Ohio., introduced the CHOICE Act to add a public option to the Affordable Care Act.

 
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