Thought some of you may be interested in this...
Elizabeth Thiers, OTR
email: [log in to unmask]
homepage: http://www.bv.net/~john/bethsot1.html
----------
> From: [log in to unmask]
> To: undisclosed-recipients:;
> Subject: NY Times
> Date: Monday, June 07, 1999 5:51 PM
>
> Health Benefits Bill Shows Power of the Disabled, 6/7/99
>
> By DAVID E. ROSENBAUM
>
> WASHINGTON -- Alana Theriault, who earns less than $1,000 a month
> working part time as a benefits counselor, is back in school to learn
> computer programming.
>
> Her instructors say she has a special aptitude, and when she
> gets her certificate soon, she says, she expects to be offered a
> programming job paying as much as $50,000 a year.
>
> But unless federal law is changed, Ms. Theriault, who is 32,
lives
> in Berkeley, Calif., and is severely disabled, may not be able to
> take such a job and may have to forfeit the self-sufficiency she
> longs for.
>
> That is because if she earns more than a pittance, she will no
> longer be entitled to Medicaid, the federal-state medical
> insurance program for the indigent.
>
> Ms. Theriault has a condition called spinal muscular atrophy.
> She needs a rented respirator to breathe, which costs $2,900 a
> month; a personal attendant more than eight hours a day, which
> costs about $1,700 a month; a motorized wheelchair; and
> expensive medication. She could never get private medical
> insurance on her own, and without Medicaid, even with a good
> salary, she could never afford what it costs her to live.
>
> Her pathway to independence may be a bill the Senate could
> pass as early as this week. It would allow disabled people to
> retain health benefits under Medicaid and Medicare, which
> covers disabled people with financial assets that make them
> ineligible for Medicaid, even if they go to work and earn too
> much to be entitled to the federal disability benefits to which
the
> health insurance is tied.
>
> Ms. Theriault says the bill would change her life. "Here I am,"
> she said in an interview, "32 years old, trying to plan for my
> future, and as things stand now, I can't take a job. I can't buy
a
> house. I can't have any investments. I can't even really have a
> savings account."
>
> Advocates for disabled people say that the bill, which has 79
> co-sponsors in the Senate, would be the most important
> measure since the Americans With Disabilities Act was
> approved by Congress and signed by President Bush nine
> years ago. That legislation outlawed discrimination against the
> disabled.
>
> At the White House on Friday, President Clinton said the effect
> of the current law forcing people to choose between work on the
> one hand and Medicare or Medicaid on the other was to "deny
> opportunities to millions," and he urged Congress to approve
> the changes quickly.
>
> The broad bipartisan support for the legislation, which has also
> been approved by the House Commerce Committee without
> opposition, is a testament to the considerable and growing
> political influence of the disability-rights movement.
>
> Another example arose earlier this year when disabled people
> across the country mobilized to persuade state politicians to
> drop their support of Georgia's appeal to the Supreme Court of
> a federal appeals court ruling that the state must provide
> alternatives to institutionalization for the disabled.
>
> In the Georgia case, Olmstead vs. L.C., which the
> disability-rights movement equates with Brown vs. the Board of
> Education, two women whose disabilities included mental
> retardation and mental illness and who were confined to a large
> state institution, argued that the state had the obligation under
> the Americans With Disabilities Act to offer them placement in a
> less restrictive setting like a supervised group home.
>
> The federal appeals court in Atlanta ruled last year that the
state
> did have such an obligation, and Georgia appealed. At various
> times, 26 states filed briefs in the Supreme Court supporting
> Georgia's position. In the last few months, all but seven of
those
> states have withdrawn their support, a highly unusual turnabout.
>
> Here is a sampling of what led some of the other 19 states to
> change their minds: In Pennsylvania, protesters in five cities
> camped out in offices of the state attorney general. In Maryland,
> with demonstrations threatened, Gov. Parris N. Glendening
> ordered the state's lawyers to withdraw the state's support.
>
> In Mississippi, an aggressive telephone campaign led Gov. Kirk
> Fordice to abandon the case. In California and Nebraska,
> representatives of the Protection and Advocacy System,
> federally financed agencies in each state that act as advocates
> for the disabled, persuaded the politicians not to support
> Georgia's position.
>
> Career lawyers in the various state governments had filed the
> briefs on Georgia's side. The politicians overturned them, once
> they got wind of it.
>
> Barbara Allen, managing deputy attorney general in West
> Virginia, explained the situation in her state. "I can say with
> some understatement," she said, "that the attorney general went
> through the roof."
>
> One of the seven states that still back Georgia's side is Texas,
> and advocates for the disabled say they will hold this against
> Gov. George W. Bush in his race for the Republican presidential
> nomination.
>
> Explaining Bush's position, Attorney General John Cornyn said:
> "The Olmstead decision would take from the citizens of Texas
> the ability to decide how best to address the needs of the
> disabled and would give this power to the federal courts."
>
> Those were fighting words to many disabled people who argue
> that their cause is one of civil rights. "This is pretty much
what
> George Wallace said when he stood in the schoolhouse door,"
> said Bob Kafka, who lives in Austin, Texas, and represents
> Adapt, a national organization of the disabled.
>
> When the Supreme Court heard arguments on the case this
> spring, hundreds of demonstrators organized by Adapt came to
> Washington for a rally in front of the Court. But there is little
> the advocates for the disabled can do to affect the Supreme Court
> decision, and they are concentrating on legislation.
>
> The most ambitious measure they are pushing would require
> states to give disabled people the money that states pay
> nursing homes to care for them, so the people could use the
> money, if they chose, to pay for care outside the institutions.
>
> The Congressional Budget Office estimates that the bill would
> cost the government $10 billion to $20 billion a year. Advocates
> for the disabled challenge this cost projection, but it has been
> enough to scare off support.
>
> "There is no way Congress is going to approve another $20
> billion entitlement," said a senior Senate staff member who has
> worked on the legislation.
>
> Another reason for the lack of enthusiasm is the strong influence
> of lobbyists for nursing homes. The federal government spends
> about $50 billion a year for long-term institutional care for
> disabled people, and the nursing homes will not give up the
> money without a fight.
>
> For the 1998 congressional elections, nursing home interests
> donated nearly $3 million to candidates, parties and political
> committees, according to the Center for Responsive Politics, a
> nonpartisan institute that monitors campaign contributions.
>
> But the much more modest bill now before the Senate seems to
> face smooth sailing. Called the Work Incentives Act, it would
> encourage states to provide Medicaid to the working disabled,
> free in most cases and in return for a modest premium payment
> in the case of workers with substantial salaries like the one Ms.
> Theriault hopes to earn.
>
> It would also extend the number of years that disabled people
> who work could continue to receive Medicare benefits without
> paying premiums. The Congressional Budget Office estimated
> that the measure would cost the government $800 million over
> the next five years.
>
> Despite the president's position and strong bipartisan support
> in Congress, the measure has run into one snag after another.
> Most recently, for example, Sen. Phil Gramm, R-Texas, blocked
> the legislation just before the Memorial Day recess because it
> would offset the $800 million five-year price tag by adjusting
the
> way international businesses could credit the foreign taxes they
> pay against their U.S. income taxes.
>
> Gramm does not disapprove of the disability provisions or
> even the tax measure, his staff said. But he objects to any tax
> increase that is used to pay for more government spending.
>
> The consensus in the Senate was that a way would be found
> around Gramm's objection and that the measure would be
> passed soon after the Senate returns this week.
>
> No one knows how many people would take advantage of the
> new benefits if they became available. In Oregon, where
> disabled people have been allowed since February to retain
> Medicaid if they take jobs, only 75 people out of more than
> 80,000 disabled people now on Medicaid have signed up so
> far.
>
> But for the few who have gone to work, the change has been a
> blessing. One of them, Scott Lay, 47, who has been a
> quadriplegic since he broke his neck in a diving accident 30
> years ago, was hired to coordinate the program for the state
> and is paid about $42,000 a year. It is essentially the first job
he
> has ever had.
>
> One of the most important elements of working is the
> self-esteem it provides, Lay said. "What I pay in federal and
> state taxes is almost as much as the government pays for my
> attendant care," he added. "So I'm paying back almost as much
> as I'm costing them."
>
>
>
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