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With Congress nearing its summer recess, it’s
time to consider the challenges we’ve faced this year on federal
policy issues, our hard-won progress and the advocacy work that’s
still ahead. Those challenges include:
- The threat that implementation
of a Medicare prescription drug law could actually harm many
consumers.
- Proposals for fundamentally altering and deeply cutting
the Medicaid program.
- The
Bush Administration’s discretionary budget proposal,
which would slash key federal housing programs that support
consumers,
mental health spending through the Center for Mental Health
Services, youth programming through the Department of Justice
and many
other federal social services programs.
Our extensive national and
grassroots advocacy has made a tremendous impact on these issues—by
either reversing entire proposals or removing components that
would have jeopardized
the health of
consumers.
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Although the Medicare prescription drug
law initially raised the threat that consumers would face
very restrictive formularies,advocacy
has diminished that threat. On June 10, the Centers for Medicare
and Medicaid Services (CMS) released written guidance that “all
or substantially all” of the drugs in the antidepressant,
anti psychotic and anticonvulsant categories should be included
on Medicare prescription
drug formularies.The guidance also called for special protections
for people who have been stabilized on medication in these
categories and who should be able to continue using them without
interruption.
These policies will provide important protections for people
using these medications and demonstrate that NMHA’s ongoing
talks with CMS staff have improved critical aspects of the
Medicare drug
benefit. The guidance also stated that plans should not use
management techniques such as step therapy or prior authorization
for people
already using these drugs, except in extraordinary circumstances.
This marks a significant improvement in policy and shows a
more sophisticated understanding of the complexities involved
in treating
people who have mental disorders.
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In the arena of federal program funding, the House and Senate
have made progress toward restoring much of the funding that
was slated
for deep cuts and rejecting some damaging programmatic changes
advanced by the administration. For example, our joint grassroots-national
advocacy work with Congress is successfully working toward restoring
CMHS funding for youth violence-prevention efforts (earlier
slated for a33 percent cut) and other CMHS programs that were
targeted
for cuts, and juvenile justice and supportive housing programs,
each of which faced cuts of nearly 50 percent. Substantial differences
between competing House and Senate funding bills will need to
be reconciled
over the coming months, but aggressive advocacy work gives us
reason to hope that we will avert deep funding cuts.
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Although the threat of Medicaid cuts still looms, broad-based
advocacy helped sustain bipartisan efforts in both the House
and Senate
and contain the size of future cuts. In addition, the budget
plan that Congress ultimately adopted does not specify that
these cuts must be taken from the Medicaid program; the cuts
can be
taken
from elsewhere in the budget.
With the fight over Medicaid cuts likely to heat up in the weeks
ahead, watch your e-mail for NMHA’s Federal
Legislative Updates and
Alerts, and take action on this critical issue when appropriate.
August also presents an opportunity to schedule visits with legislators
who will likely be back in their home states during at least part
of that month, an important time to discuss the dangers that Medicaid
cuts pose for consumers. Keep up the good the fight!
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