LEGISLATION WOULD FUND STUDENTS WITH DISABILITIES

Legislation to increase funding for students with disabilities may be part of the next COVID-19 relief bill. The bill entitled the Supporting Children with Disabilities During COVID-19 Act appropriates $11 billion for state grants under the Individuals with Disabilities Education Act (IDEA).

Furthermore, the legislation would fund $1.2 billion for early childhood education programs, $55 million under the Assistive Technology Act of 1998, and requires recipients of funds to report to Congress how this money is spent.

There may be an $430 billion to support childcare, K-12 schools, and higher education in the bill, but that is far from a settled matter. Greater support for students who experience disabilities has been a theme of many discussions leading up to this legislation. It was assumed from the beginning that a second round of stimulus legislation would be needed and this recent effort is the product of that need.

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JOHN LEWIS’S LAST LEGISLATIVE EFFORT WAS IN SUPPORT OF EDUCATION

One of the late John Lewis’s last legislative efforts was directed toward supporting two Center for Civic Education grant applications. These grants fund the Supporting Effective Educator Development (SEED) Program. The grants which total $25.9 million over three years, would expand the Center’s work to provide teachers with professional development in the fields of elementary, middle, and high school civics and government across the country.

In 2015, the U.S Department of Education awarded the Center a multi-year SEED Program grant to fund a nationwide teacher professional development program in the fields of civics and government to increase student achievement in these subjects.

Prior SEED Program grant funding allowed the Center to provide professional development to over 2,000 teachers. Teacher expertise, as research has consistently shown, is one of the most important factors in raising student achievement. Currently the Center’s 2015 SEED Program grant funding is essentially exhausted.

Lewis who died on July 17th, was a civil-rights leader who served in the United States House of Representatives for Georgia’s 5th congressional district from 1987 until his death in 2020 from pancreatic cancer. In 1961, Lewis became one of the 13 original Freedom Riders and was beaten in 1965 by Alabama state troopers on what became known as “Bloody Sunday”.

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SENATORS SEEK AMTRAK FUNDING

Multiple North East states are dependent upon Amtrak. The Northeast Corridor (NEC), states could not afford for Amtrak to cease in its operations. This is why multiple U.S. Senators are pushing for additional funding for the rail carrier in the next COVID-19 relief bill.

The senators are seeking funding for upgrades in infrastructure projects that are needed by Amtrak. The pandemic has sharply reduced the ridership of Amtrak and the fear is that this will be the pretext for budget cuts to the service.

Because the Northeast Corridor (NEC) is the busiest passenger rail corridor in North America, NEC states along the route have a valid concern about the longevity of Amtrak. Above and beyond the infrastructure funding, Senators are seeking workforce protection for Amtrak as well as other critical projects.

The 457-mile NEC rail network between Washington, D.C. and Boston Massachusetts provided 750,000 trips each day serving a workforce that contributes more than $50 billion annually to the national economy. However, the NEC needs significant upgrades as crucial segments are at or near capacity and portions of the rail line are over a century old.

Amtrak and the NEC states have been working for years to reserve funding to address the critical backlog of projects, which will create thousands of good-paying jobs and improve the performance of the corridor.

Whether it’s a state of good repair project to improve Penn Station, an Americans with Disabilities Act compliance project, new Acela trainsets, or much-needed upgrades to ensure service reliability, these projects are critical to the continued success of Amtrak and all the commuter rail service that operates on the NEC.

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STATES SEEK TO STOP HHS DISCRIMINATORY INSURANCE RULE

Twenty one states are filing a lawsuit to stop a new Trump Administration rule that makes it easier for health care providers and insurance companies to discriminate against certain vulnerable and protected classes of Americans.

In a lawsuit filed against the U.S. Department of Health and Human Services (HHS), HHS Secretary Alex Azar, and the head of HHS’s Office of Civil Rights, Roger Severino, the coalition of states argue that the new rule emboldens providers and insurers to discriminate against LGBTQ+ individuals, those with limited English proficiency, and women, among others, by stripping express protections for these groups in HHS regulations that implement the nondiscrimination provision of the Patient Protection and Affordable Care Act (ACA).

Provisions of the ACA prohibit discrimination based on race, color, national origin, sex, disability, or age by health programs or facilities that receive federal funds, but the Trump Administration is seeking to undermine many of those protections.

The Obama Administration’s HHS issued regulations implementing Section 1557 of the ACA in 2016 — making clear that discrimination on the basis of gender identity, nonconformity to sex stereotypes, and pregnancy status are forms of sex discrimination prohibited by the statute. Specifically, Section 1557 prohibits discrimination by any health care program — including providers and insurers — against individuals on the basis of race, color, national origin, sex, disability, or age.

Federal courts have also held that the statute’s prohibitions on sex discrimination protect transgender and other LGBTQ+ individuals from discrimination, which was confirmed in last month’s Supreme Court decision in Bostock v. Clayton County, which held that discrimination based on sexual orientation and transgender status are forms of sex discrimination prohibited by federal civil rights law.

But, despite numerous failed legislative and legal battles to repeal and dismantle the ACA, the Trump Administration’s new rule would now eliminate many of the express protections contained in the Section 1557 regulations, unlawfully exclude many health insurers from Section 1557’s scope, and would embolden health care providers and health insurers to deny care and insurance coverage. The new rule would also impose unreasonable barriers and impede timely access to health care for Americans, in violation of Section 1554 of the ACA.

Before the rule was finalized, the states called on the Trump Administration to withdraw the rule by submitting a comment letter to HHS last August, as well as by sending a letter to HHS this past April, at the start of the coronavirus disease 2019 (COVID-19) public health crisis, in an effort to stop the further exacerbation of the nation’s health care system.

The states argue that HHS has unlawfully ignored the harms that the new rule will impose on vulnerable populations, including LGBTQ+ individuals, individuals with limited English proficiency, and women, as well as other protected classes. The coalition additionally contends that HHS has failed to justify why it abandoned its prior policy, which, among other things, explicitly prohibited discrimination in health care and required health entities to provide meaningful language assistance services to individuals with limited English proficiency, including notifying them of their rights to translation and interpretation services. The lawsuit finally alleges that the Trump Administration was motivated by animus toward the transgender community in issuing this rule.

Furthermore, the states claim that the new rule is arbitrary, capricious, and contrary to law under the Administrative Procedure Act (APA), and that it violates the equal protection guarantee of the Fifth Amendment.

Posted in ACA, Affordable Care Act, DISCRIMINATION, HHS, INSURANCE, INSURANCE COVERAGE, LGBTQ, OBAMACARE, U.S. Department of Health and Human Services | Leave a comment

STATE SUES EPA OVER MERCURY AND AIR TOXICS STANDARDS

Connecticut is suing the U.S. Environmental Protection Agency (EPA) over its rule reversing the agency’s determination — first made nearly 20 years ago — that it is “appropriate and necessary” under the Clean Air Act to regulate mercury and other toxic air pollution from coal- and oil-fired power plants.

The new rule undermines the 2012 Mercury and Air Toxics Standards (MATS), a landmark rule that has substantially reduced emissions of mercury and other hazardous pollutants that harm human health and the environment, and that pose especially significant health risks to children and pregnant women.

This lawsuit, filed in the U.S. Court of Appeals for the District of Columbia Circuit, challenges EPA’s reversal of its finding that the MATS regulation is “appropriate and necessary.” Over the past two decades, EPA has made such a finding no less than three times, relying on a growing body of scientific evidence, because power plants are the country’s largest source of hazardous pollutants, and because other provisions of the Clean Air Act would not adequately reduce those emissions.

The agency’s final rule seeks to undermine MATS even though power plants have been complying with the standards since 2015 and already have installed the pollution-control technologies.

Mercury has especially adverse effects on the developing brains of fetuses and children. A child exposed to mercury consumed during pregnancy can suffer permanent neurological damage and a lifelong loss of IQ. Mercury exposure is also linked to an increased risk of diabetes, autoimmune dysfunction, and cardiovascular issues in adults. A 2016 study projected that the total benefits associated with reducing mercury under MATS through 2050 would amount to at least $43 billion.

The primary route through which humans are exposed to mercury is by consuming fish. Airborne mercury from power plants falls back to earth, where it is converted into methylmercury, a potent neurotoxin that accumulates in increasing quantities as it moves up the food chain, particularly in fish. Mercury emissions from power plants have been a major contributor to mercury contamination of U.S. waterways. As of 2011, that contamination was so widespread that fish consumption advisories were in place in all 50 states.

Mercury pollution in lakes and rivers hurts local fishing economies and deprives residents across the country of the ability to enjoy recreational fishing and commercially harvested seafood. It also results in serious harms to wildlife.

In addition to effectively controlling mercury and other toxic metals — like arsenic and chromium —MATS has led to a dramatic reduction in the fine particulate matter emitted by power plants. Particulate matter is strongly linked to premature death, aggravated asthma, chronic bronchitis, and other cardiopulmonary illnesses that disproportionately affect many minority and low-income communities. In April, researchers at the Harvard T.H. Chan School of Public Health released a study linking long-term exposure to fine particulate matter with increased COVID-19 death rates.

In April 2019, a coalition of 26 states, counties, and cities in submitted comments to EPA opposing the agency’s then proposed rule to undermine MATS. The comments argued that the agency does not have the authority to reverse its previous finding and underscored that MATS is providing enormous health, environmental, and economic benefits to the residents of the states and local governments — and at a fraction of the predicted cost.

Posted in AIR, Clean Air Act, ENVIRONMENT, MATS, MERCURY, Mercury and Air Toxics Standards, TOXIC STANDARDS | Leave a comment

SENATORS EXPRESS SUPPORT FOR HEROES ACT

Thirty-Five U.S. Senators are supporting the funding amount and proposed funding flexibility for state and local governments that was included in the HEROES Act passed by the U.S. House of Representatives. The Senators have sent a letter to Senate Majority Leader Mitch McConnell (R-KY) requesting that he support the legislation as well. The funding includes $500 billion for states, $375 billion for local governments and $20 billion each for territories and tribal lands.

As state and local governments report anticipated cuts to their budgets, this will invariably affect such services as public schools, social services and health departments, with widespread economic consequences. Local and state governments expect cuts in services to local health departments which employ essential workers during the COVID-19 pandemic, as well as child welfare workers, social workers, firefighters and more employees.

Many county and state governments have been forced to furlough workers due to the pandemic, and without funding, these furloughs could become permanent job losses. Decreased local government spending may lead to a $344 billion decrease in economic output and 4.9 million less jobs.

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PANDEMIC EXACERBATES ANTIRETROVIRAL SUPPLY SHORTAGE

The COVID-19 pandemic has placed a strain on the supply of antiretroviral drugs. The lack of planning and the continued silence as to how to correct this issue by the Trump Administration is now placing a strain on the supply of antiretroviral drugs in the United States.

As of now, there is no plan by the Trump Administration to stem the shortage of these drugs while the United States continues to fight the COVID-19 pandemic. To compound the problem the United States since the 1990’s has been importing the bulk of its antiretroviral drugs from China.

The current state of relations between the two nations is strained over trade issues and this could be a serious problem if there is a shortage and the antiretroviral drugs somehow become a political negotiating tool for China.

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BILL COULD REMOVE TANEY BUST FROM OLD SUPREME COURT CHAMBER

A bill to remove the bust of Chief Justice Roger B. Taney in the Old Supreme Court Chamber with one of Justice Thurgood Marshall has been introduced. This is legislation is a continuation of the nationwide reckoning of slavery and racial inequality spurred by the murder of George Floyd.

H.R. 7573 require states to reclaim and replace any statues in the National Statuary Hall Collection of individuals who volunteered for the armed services of the Confederacy during the Civil War. It would also specifically remove three statues – of John C. Calhoun, Charles B. Aycock, and John C. Clarke – from the collection because of those individuals’ role in defending slavery, segregation, and white supremacy.

The case of Dred Scott v. Sandford, 60 U.S. (19 How.) 393 (1857), was heard by the Taney court and the decision was written by Chief Justice Taney. The Court ruled that black people “are not included, and were not intended to be included, under the word ‘citizens’ in the Constitution, and can therefore claim none of the rights and privileges which that instrument provides for and secures to citizens of the United States.” This case has become infamous over the decades since.

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BEHAVIORAL HEALTH BILL PASSES ENERGY AND COMMERCE COMMITTEE

A bipartisan vote has led to the passage of the Strengthening Behavioral Health Parity Act by the House Energy and Commerce Committee. Under the legislation, the Department of Labor will be required to conduct random audits, and if they find that insurance plans are not abiding by existing parity laws, they will either be able to correct their actions or face public scrutiny for not doing so.

This is not the first attempt at such legislation in recent years. A similar bill the Behavioral Health Coverage Transparency Act was introduced in 2015. That legislation would have strengthened accountability, increased transparency and created a patient portal for parity violations. In 2019, the Mental Health Parity Compliance Act was introduced which would require audits to improve health plan compliance with existing law.

The House Committee-passed Strengthening Behavioral Parity Act (H.R. 7539) would:

• Require employer plans to treat out-of-network behavioral health providers the same as out-of-network medical and surgical providers;

• Create additional mental health and substance use disorder parity requirements for employer health plans;

• Require employer plans to provide the criteria for medical necessity determinations to behavioral health providers upon request; and

• Require the U.S. Department of Labor to conduct random audits of health plans.

Significant mental health coverage issues remain: According to a recent Milliman report, “The out-of-network utilization rates for behavioral healthcare providers were higher than for medical/surgical providers in all five years (analyzed 2013-17),” and patients are nearly six times more likely to use out-of-network providers for behavioral treatment than those for physical health treatment.

As the law stands now, employers must ensure “non-quantifiable treatment limitations” for mental health benefits are the same as those for medical and surgical benefits. This includes prior authorization, medical management standards, prescription drug formulary design, standards for provider admission to networks, determination of provider reimbursement rates, requirements for step therapy, and requirements to complete a course of treatment. The Strengthening Behavioral Health Parity Act would expand that mandate.

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VETERANS BILL AMENDMENT ATTACHED TO THE NATIONAL DEFENSE AUTHORIZATION ACT

A bill to assist veterans exposed to Karshi-Khanabad or K2 was introduced this week. The K2 Veterans Toxic Exposure Accountability Act of 2020 was introduced as a floor amendment to the Fiscal Year 2021 National Defense Authorization Act (NDAA).

The bill directs the Department of Defense (DOD) and the Department of Veterans Affairs (VA) to study the hazards that American servicemembers were exposed to while deployed to K2, a former Soviet Air Base in Uzbekistan, and address the health conditions that may have been caused by these exposures.

In January, the House Oversight Committee first requested information from DOD and the VA about press reports that U.S. servicemembers and special operations forces who deployed to K2 after September 11, 2001 were exposed to cancer-causing hazards.

On June 29, after months of withholding documents from Congress it had already declassified, DOD shared its 2001, 2002, and 2004 K2 environmental hazard surveys and health risk assessments in response to requests from Chairman Lynch and Rep. Green. These documents revealed that:

• K2 servicemembers were exposed to multiple toxic hazards, from hazardous petrochemicals such as jet fuel and kerosene to particulate matter and burn pits.

• Up to 100% of the units assigned to K2 were potentially exposed to radiation.

• Military leaders were supposed to communicate with K2 servicemembers about potential health risks.

• K2 members were told repeatedly that no significant risk from hazards existed.

• Multiple “false-positive” readings detecting nerve, mustard, and blood agents were attributed to faulty test equipment.

This amendment would require the VA to determine whether K2 veterans diagnosed with certain health conditions should be eligible for disability benefits. The amendment would also make K2 veterans eligible for the VA burn pits registry and depleted uranium follow-up program.

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