Live From DC:Federal Aging Policy Update

Sandy Markwood, CEONeal Karkhanis, Manager, Public PolicyJune 17, 2013

n4a 2013 Policy Priorities• Reauthorize Older Americans Act• Enhancing the Health of Older Adults• Preserving the Safety Net• FY 2014 Appropriations• Promoting Community Living &

Mobility

Agenda• State of Sequester, FY 2013• Future Prospects for Sequester• FY 2014 Approps Advocacy• Fall Showdown?• Older Americans Act

Reauthorization

A Tale of Two Fiscal Years• FY 2013 Funding

– Should have been final by Oct. 1, 2012

– Was made final in late March 2013– Sequestration in Effect

• FY 2014 Budgets– President’s budget was 9 weeks late – House and Senate early and

complete!– No chance of conferenced budget– Approps process has begun

• Went into effect on March 1; ACL released final state-specific numbers around May 31. Available to public at www.aoa.gov

• Roughly 5 percent across-the-board cut butsome OAA programs affected differently based on formulas, so wide range between states in III B (11 states with double digit cuts), some odd swings in III C, etc.

Sequestration

Continues until Congress turns it off, or it stops in 2021!

Sequestration

• BCA continues sequester through 2021.• “Out years” (FY ‘14-’21) sequester

operates differently.• Forces the BCA caps lower instead of an

across-the-board cut• Pressure is on appropriators to decide

where to cut, but pie made much smaller

Sequestration

Source: cbpp.org

• Focus has rightly moved from Advocacy Administration

• What’s best for your clients doesn’t usually make the best news story

• How will we get sequester turned off if harms aren’t evident?

Sequestration Quandary

• Transparency is important (Carry-over funds, one-time options, transfer authority, etc.)

• What “magic” did you work this year that you wouldn’t be able to next year?

• Are you ready for the press calls when you close a program?

Sequestration Messaging

• Plan your message• Make clear sequestration’s role• Make clear it would be worse but for…• Make clear it will get worse if it continues• Make clear why this choice to take the hit• Keep circling back to the need in your

community and what you need to meet it

Sequestration & Media

• Continued direct advocacy • n4a Sequestration Central

• Op-ed examples from your peers• Media hits to learn from

• 1st Survey complete; report soon!

n4a Sequestration Efforts

State of Deficit Reduction (DR)DR Enacted Since 2010: • $1.6 trillion largely from

discretionary (CR, BCA, ATRA) • $0.7 trillion in revenues (ATRA)• $0.45 trillion in interest savings • $2.75 trillion in total deficit

reduction

(Source: CBPP)

State of Deficit Reduction• “Grand Bargain” was in the $4

trillion range, so $2.75 tril already done is significant

• Ctr on Budget and Policy Priorities says to stabilize the debt, we need to find $1.5 trillion (1.3 + .2 interest savings) more in DR

Where did the DR come from?

16

NDD categories

NDD Funding• Spiked with stimulus (ARRA)

efforts, but had already dropped back to historical levels before BCA

• BCA caps alone force it down (in relation to GDP)

• Sequester deepens the wound• Further cuts would be devastating

FY 2014 Budget Process

• In March, the House and Senate voted on and passed two dramatically different budget resolutions.

• March 21, House passed Budget Chairman Paul Ryan’s (R-WI) plan (221 to 207)

• March 23, Senate passed Budget Patty Murray’s (D-WA) plan (50 to 49)

House and Senate Budget Resolutions

• Seeks to balance federal budget through $4.6 trillion in federal spending cuts.

• Several cuts to programs including Medicare, Medicaid, NDD

• All cuts; no new taxes; lowers taxes• Lowers corporate tax rate from 35% to

25%• Collapses the current income tax brackets

down to two: 25% and 10%

House Budget Resolution Key Highlights

• Utilizes overall discretionary spending cap of $966 billion for FY 2014 (in line with BCA)

• Extends BCA caps an additional two years (through 2023 instead of 2021)

• Raises defense BCA caps to pre-BCA levels, offset by lowering caps(cutting) non-defense discretionary

• Sequestration stays in effect

House Budget Resolution Key Highlights

• Utilizes overall discretionary spending cap of $966 billion set by BCA of 2011

• Counts $2.4 trillion in deficit reduction already achieved by 112th Congress and President (majority of cuts came from NDD)

Senate Budget Resolution Key Highlights

• Fully replaces sequestration with balanced deficit reduction measures • half new revenues, half cuts split

evenly between defense and NDD

Senate Budget Resolution Key Highlights

• Turns off sequester for remaining 9 years• $200 billion contribution from

discretionary to the package of revenues/cuts that pay for this aversion

• $400 bil Medicare• $230 bil Social Security (chained CPI)• $580 bil new revenues

President’s FY 2014 Budget

OLDER AMERICANS ACT• Core programs level funded at FY 2012

levels• Exception: Title V SCSEP cut 15% ($68

million cut out of $448 million program)

President’s FY 2014 Budget

ADMINISTRATION FOR COMMUNITY LIVING• 1st budget as consolidated agency• Movement: Asking for OAA Title V and SHIPs to

move from DOL/CMS over to ACL• Increases: Proposes new and restored

Alzheimer’s funding (some PPHF); boosts APS to $8 million (from approps)

• PPHF requests: $10 mil CDMSP and $10.5 Alzheimer’s Initiative

• No $ requested for falls prevention

President’s FY 2014 Budget

House• Follows House Budget Resolution, post-sequester

levels and deeper hits to NDD

Senate • Chair Barbara Mikulski (D-MD) ignores the sequester

Result is they start $91 billion apart at the starting gate!

Appropriations Process

• No real conference committee on budget resolutions

• Appropriators will begin work; so we must as well!

• Debt ceiling fight is next opportunity to turn off sequester, make other deficit deals…or face a shut-down or default!

What’s Next?

Call to Action• Continue to engage your Members

of Congress. Let them know how the sequester will affect your community’s federally funded programs, your agency’s ability to meet the needs of your clients, and the ripple effects on the health and independence of older adults and caregivers.

• Keep them informed about major changes you are forced to make.

Older Americans Act Reauthorization

n4a’s OAA Reauthorization Priorities

• Preserve the Act’s flexibility and person-centered approach

• Strengthen the Aging Network’s role and capacity in the coordination and provision of home and community-based services

• Expand evidence-based health promotion and disease prevention

• Improve community preparedness for an aging population

• Set adequate authorization levels

Reauthorization of OAATIMELINE

• AoA Listening Sessions, Winter 2010• Groups survey members, write

recommendations, release by spring 2011

• Senate HELP Subcomm holds listening sessions, summer 2011

• Act “expires” Sept. 30, 2011• Fall 2011: AoA shares tech asst for Hill• 2012: 2 Sanders OAA bills introduced• May 23, 2013: S. 1028 Introduced

S. 1028 Co-SponsorsSen Baldwin, Tammy [WI]Sen Blumenthal, Richard [CT]Sen Boxer, Barbara [CA] Sen Cardin, Benjamin L. [MD]Sen Casey, Robert P., Jr. [PA]Sen Franken, Al [MN]Sen Gillibrand, Kirsten E. [NY]Sen Johnson, Tim [SD]Sen Klobuchar, Amy [MN]Sen Leahy, Patrick J. [VT]Sen Merkley, Jeff [OR]Sen Nelson, Bill [FL]Sen Schatz, Brian [HI]Sen Warren, Elizabeth [MA]

What’s in the bill?• Adding new categories to definition

of greatest social need (LGBT, HIV/AIDS, Alzheimer’s, Holocaust Survivors)

• Few national resource centers authorized (caregiver, women & retirement, LGBT)

• Sense of the Senate OAA needs more $

• Study of legal services coord.

And…• Elder justice, reporting• Caregiver assessments, state

option• Home care ombudsmen programs

and home care consumer bill of rights

• Quality assurance/measurements for home care

OAA Reauthorization Timeline• June 19 Senate HELP hearing on

hunger/poverty/OAA• End of July Mark-Up ?• House still busy with other bills• We will need strong advocacy to

make Congress pay attention, get it right and keep it moving!

Register Now!n4a Annual Conference & TradeshowJuly 27-31, 2013Louisville, KYwww.n4a.org

Save the Date!Aging Policy Briefing April 28-29, 2014Capitol Hill

Questions?Call on n4a’s Public Policy &

Advocacy Staff

Amy E. Gotwals, agotwals@n4a.orgNeal Karkhanis, nkarkhanis@n4a.org

www.n4a.org/advocacywww.twitter.com/n4aACTION www.twitter.com/amygotwals