News from the Hill – May 2010, First Edition

May 14, 2010

Political Climate

With the health care debate now behind us, Capitol Hill and the Obama Administration have moved on to other things.  Issues of great significance include a pending Supreme Court nomination, fluctuating news on employment, and several Congressional primary races that will give shape to the November general election.  At this point in the year, many Members of Congress are focused on both a wide range of policy issues as well as their reelection prospects.

While Democrats are expected to suffer losses this year, experts widely disagree on the number (House seat estimates have ranged from 25 all the way to 60).  That said, it’s important to remember one thing about any election in which the minority party is trying to overwhelm the majority party: only in the summer and fall are the challengers truly tested, in both fundraising and campaigning.  Those Republican candidates trying to defeat entrenched Democrats will have to maintain a significant fundraising pace and avoid gaffes on the campaign trail.  Any error in either category could cost the GOP potential seats.

These remarks are not meant to be partisan in nature because the Democrats were in a similar position in 2006 as well as 2008.  In each of those years some Democratic challengers were unable to defeat Republican incumbents due to either lackluster fundraising, a disappointing campaign, or both.  At the same time, the Democrats won a significant number of seats in the House and the Senate, eventually taking over the majority.  The GOP is likely to repeat that pattern this year, enjoying a sizeable number of wins, but not necessarily as many as their most optimistic supporters would like.

Remembering Dr. Dorothy I. Height

NASW and the social work community were devastated by the loss of Dr. Dorothy I. Height on April 20, 2010. One of the world’s most important social workers, Dr. Height was a civil rights legend who spent a lifetime advocating for the rights of women and people of color. Dr. Height worked on five continents for four major national organizations during her lifetime. Dr. Height was the only female team member in the United Civil Rights Leadership which included Dr. Martin Luther King, Jr.,  Whitney Young, A. Philip Randolph, James Farmer, Roy Wilkins and John Lewis. She received the Presidential Medal of Freedom in 1997, the Congressional Gold Medal in 2004, and was inducted into the Democracy Hall of Fame International. NASW was honored to award Dr. Height with the 2009 Lifetime Achievement Award.

The most comprehensive piece of federal legislation ever introduced to address social work workforce challenges was named after Dr. Height and fellow social worker Whitney Young. NASW Executive Director Dr. Elizabeth Clark penned a tribute to Dr. Height and discussed her support of the legislation bearing her name. Honor the legacy of Dr. Height today by contacting your Representative and Senators in support of this critical legislation.

NASW Joins Young Invincibles In Support of Early Dependent Coverage

NASW joined 65 state and national groups on a letter asking insurance companies to start dependent coverage early.  The letter was generated by Young Invincibles, a national youth advocacy group focused on health reform. 

An important provision in the health care law allows young adults to stay on their parent’s plan until their 26th birthday.  These early dependent coverage steps would apply to non-college youth (for example, a working 19 year old looking to go back on their parents’ plan) and to students on student plans that might be able to switch back to their parents’ plan post-graduation.  This provision of health care reform starts on September 23, but several insurance companies have decided to start the rule early.  With about 3.2 million students graduating from college in May, and 67% of those on their parents’ plan, early dependent coverage is critical.

The letter states, “The extension of dependent coverage to the age of 26 is one of several provisions that positively impacts young Americans; this provision alone will provide coverage to more than 2 million uninsured young adults. Taken together, the provisions in the health care reform law will guarantee that millions more young adults have access to quality, affordable insurance.”

Secretary Sebelius Speaks to LCAO

On May 5, Kathleen Sebelius, Secretary of Health and Human Services gave a brief presentation to the Leadership Council of Aging Organizations (LCAO) regarding the recent health care law.  LCAO is a coalition of national not-for-profit organizations representing nearly 60 million older Americans.  During her remarks, Secretary Sebelius talked about the timeline for implementation of the law, including early implementation of dependent coverage and the early retiree provision.  She also encouraged LCAO members to continue to partner with the Administration on implementation strategies.  To learn more about the timeline for implementation for key provisions, please go here:

In related news, NASW joined LCAO in a letter to congressional members thanking them for passage of the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010.  The letter outlined important benefits for seniors contained in the law such as:

  • strengthening Medicare’s guaranteed benefits,
  • eliminating barriers to preventive care, extending the solvency of the Medicare Trust Fund,
  • shoring up retiree health coverage, and cracking down on insurance company abuses, such as denying affordable coverage because of age or health status.

In addition, the new law will also help Americans remain in their own homes as they age by establishing a new program to help pay for long-term services and supports and enhancing Medicaid’s role in providing this assistance.

Congress Reconsiders Medicare Rates

For the third time this year, Congress confronts a scheduled 21 percent cut in payment rates to Medicare practitioners who bill Part B independently, including physicians and clinical social workers. The political obstacle to congressional action remains the large cost of a long-term correction of the law governing rates, leading to correction bills that address the formula problem with only stopgap delays. The last short-term extension of the payment formula was adopted in April and delayed a decision on practitioner rates until May 31; see NASW’s last update here.

The payment formula was initially enacted in 1997 as part of the Balanced Budget Act, which capped the maximum growth in total Medicare Part B expenditures.  The formula treats all independent practitioners as a group, and if Medicare payment growth exceeds a target set in statute, rates are cut the following year to make up the difference. According to survey data from the AMA (here), physicians’ frustration with payment rates has reached a level that many are now reluctant to take on new Medicare patients.

This year, because Congress has adopted more stringent budget process rules, they have been unable to muster the votes necessary for a year-long extension. Instead they have fallen back on extension bills that endure for only a month or two that show a lower impact on spending. A recent Congressional Budget Office estimate placed the cost of a Medicare payment rate delay at $276 billion for the next decade.

Complicating matters for clinical social workers, changes in other components of the SGR have also affected their payments rates for 2010, including several regulatory actions taken by the Center for Medicare and Medicaid Services (CMS). A briefing on these separate payment changes is available on NASW’s website here, check under the subtitle, “Reimbursement.”  Please have your membership information ready to log onto the page.

Congress Begins Annual Appropriations Process

Each year Congress makes funding decisions for a wide variety of domestic and international programs and activities that require an annual appropriations amount. Entitlement programs, such as Medicaid, SSI, Medicare and Social Security are not part of this process, but programs such as drug and alcohol prevention and treatments,HIV/AIDS and workforce development are key priorities under consideration. NASW is currently making visits to appropriations committee members, urging funding increases in areas such as social work workforce training and services for vulnerable populations.

President Obama Nominates Elena Kagan for Supreme Court Justice

Elena Kagan is currently the Solicitor General, the first woman in this post. As Solicitor General she represents the Administration before the Supreme Court. If she is confirmed by the Senate as a Supreme Court Justice, one-third of the court will be women, another first. Ms. Kagan would replace John Paul Stevens following his retirement. Ms. Kagan is widely regarded as one of the best legal minds of her generation. She was the first female dean of the Harvard Law School where she developed an atmosphere of openness to other viewpoints and consensus building.

Advocacy Blog Roundup

NASW Recognizes National Minority Cancer Awareness Week

Equal Pay

Support Incentive Payments for Clinical Social Workers in Medicare/Medicaid

Congress Remembers Dr. Dorothy I. Height

Advocacy Listserv Activity

In the month of April, 1,061 activists sent 1,419 advocacy messages to Congress through Capwiz. The most active alerts were about Incentive Payments for Clinical Social Workers in Medicare/Medicaid and the Employment Nondiscrimination Act.  Thanks to all of you who took the time to take action!  For more information, go to

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