National Alliance on Mental Illness
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Obama Administration Hits the Ground Running – Economic Stimulus, Children's Health and Budget Measures Achieved in First Month in Office
February 27, 2009
President Obama presented his first prime-time address to Congress and the nation this week. In addition to issues relating to the current economic crisis, much of his address focused on longer-term goals. Andrew Sperling, NAMI’s director of federal legislative advocacy, provides the following summary of federal activity of note to individuals and families affected by mental illness.
The first month of Obama’s residency has seen a flurry of activity on a broad range of legislation and policy, including passage of economic stimulus and recovery legislation, a childrens’ health insurance bill, spending legislation for the current fiscal year, and the release of a massive fiscal plan for the coming decade featuring a bold initiative on health reform.
NAMI is monitoring all of this very closely and has been pressing for inclusion of provisions to protect programs serving children and adults living with mental illness in these difficult economic times. Included below are just a few of the highlights of what has been a very busy first month of the new Obama Administration.
Enactment of the Economic Stimulus and Recovery Package
On February 17, 2009, the President signed in to law the massive $787 billion economic recovery and stimulus package. The bill, known as the American Recovery and Reinvestment Act of 2009 (HR 1), includes a broad range of tax cuts, aid to states and investments in health care.
There are a broad range of provisions that are expected to have a major impact on public programs and agencies serving children and adults with serious mental illnesses – at the federal, state, and local level. These include critical investments to shore up safety net programs such as Medicaid, disability benefits, supportive housing, and special education. In addition, the new law includes additional funding for medical research and health information technology.
Review an analysis of the major provisions in the American Recovery and Reinvestment Act impacting children and adults living with mental illness.
Passage of Children’s Health Insurance Legislation
On February 4, 2009, President Obama signed legislation reauthorizing the State Children’s Health Insurance Program (SCHIP). The bill (HR 2) is similar to bills that were vetoed by former President Bush in 2007 and 2008. The new law will expand the current SCHIP program to cover approximately four million additional uninsured children. More importantly, it ensures that all private sector SCHIP plans comply with the Paul Wellstone & Pete Domenici Mental Health Parity and Addiction Equity Act of 2008–the new federal parity law.
The expanded coverage in the new law is financed through a 61-cent increase in the federal tobacco tax. The new law also makes it easier for people who are U.S. citizens to document their citizenship status by allowing access to government databases (but extends the requirement to document citizenship to SCHIP, whereas before it had applied only to Medicaid). Finally, the new law allows states to cover children in families with incomes up to 300 percent of the federal poverty level with full federal SCHIP funding but does not establish a "cap" on eligibility level.
Review additional details on the new SCHIP law.
Completion of a Current Year Spending Package Covering Research Services and Housing
The Obama Administration and Congress moved earlier this week to complete action on the current year’s federal budget and to begin the process for enactment of a budget for 2010. This puts in place spending levels for mental illness research, services, and housing programs for the remaining seven months of FY 2009 (through September 30, 2009).
By a vote of 245-178, the House on February 24, 2009, cleared a massive $410 billion "Omnibus" spending bill covering the rest of the current federal fiscal year (FY 2009). Overall the bill (HR 1105) would increase spending for a broad range of domestic discretionary programs and agencies an average of 8.7 percent. For nearly five months, these agencies and programs have been operating under a "continuing resolution"– keeping funding levels at FY 2008 levels since October 1, 2008. The current "continuing resolution" runs through March 6, 2009. The Senate is expected to take up the spending bill early next week. Among the critical investments in the FY 2009 "Omnibus" Appropriations bill are:
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$43.4 million for mental illness research;
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$58.3 million for mental illness services;
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$13 million for the HUD Section 811 program; and
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$91 million for HUD homeless programs.
View details on provisions in the final FY 2009 funding bill for mental illness research, services, and housing programs.
Proposal of a Budget for 2010 and Outlines of a Major Health Care Reform Proposal
On February 26, 2009, the White House released the broad outlines of a FY 2010 budget. The document contains few details on proposed funding levels of individual programs. However, it does set forth budget priorities in a number of key areas, most prominently comprehensive health care reform.
It is expected that a more detailed proposal, including specific funding levels for domestic programs, is forthcoming from the Obama Administration by early April. However, the budget released today does set forth the outlines of the President's priorities with respect to health reform. Chief among these is a $634 billion fund designed to finance expansion of health coverage for the uninsured over the coming decade – what is being termed "a major down payment toward universal coverage." This would be financed by reductions to Medicare managed care plans (known as Medicare Advantage), reductions in Medicare payments to doctors and hospitals, and allowing certain tax breaks to expire.
View the President's budget submission to Congress.