Legislative Update 6/1/2021: Blueprint for Federal Budget and Nebraska State Legislature

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This is the legislative update for June 1, 2021. View all updates here.



The June 1, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates

Congress

Just before Congress left Washington for Memorial Day, President Joe Biden released the blueprint of his $6 trillion budget proposal. The blueprint ties together three major spending proposals already announced by President Biden:

  • The $2.3 trillion American Jobs Plan, which includes:
    • Fixing highways, rebuilding bridges, and upgrading our transit systems
    • Replacing all lead pipes and service lines in our drinking water systems
    • Investing in the infrastructure of our healthcare economy and creating new jobs
  • The $1.8 trillion American Families Plan, which includes:
    • Investing in the middle class including education by adding four years of free education
    • Creating a national Family and Medical Leave Act (FMLA) program for maternity and sick leave
    • Boosting funding for maternal and infant healthcare costs
    • Increasing Supplemental Nutrition Assistance Program (SNAP) benefits
    • Ensuring that low-to-middle class families pay no more than 7% of their income on childcare
  • The $1.5 trillion in discretionary spending for FY 2022, with notable items including:
    • $6.5 billion to launch ARPA-H — a historic $20 billion increase for Title I schools (Translation: Schools that receive federal funding to support education for low-income homes) to advance educational opportunity for all students
    • $8.7 billion — the largest funding increase in 20 years, for the Centers for Disease Control and Prevention (CDC) to help rebuild its capacity to detect, prepare for, and respond to emerging global threats
    • $36 billion in investments to tackle the climate change crisis

Combined with mandatory spending programs, the 2022 budget proposal would spend about $300 billion more than current projections for the year. Much of the spending will be going toward education, health, science research, and infrastructure. It’s assumed that in order to pay for most of the additional costs of the budget proposal, there will be an increased tax on wealthy Americans.

Budget and Healthcare

The budget reiterates the President’s request to Congress to reduce the costs of prescription drugs, expand health coverage, and improve access by strengthening the Affordable Care Act (ACA), Medicare, and Medicaid coverage — while also creating additional public coverage options.

The president campaigned on establishing a public option, saying it could help build access to health insurance without going the “Medicare for All” route and ending private insurance. However, despite his support of a public option, his proposed budget does not assume that a public option proposal will pass. This has left many people wondering how such a proposal would be considered for funding and sustainability.

Budget-Specific Provisions that Invest in Children

Provisions that directly affect children include:

  • $16 billion for the Individuals with Disabilities Education Act (IDEA) grants that would support special education and related services for more than 7.6 million students in preschool through grade 12. This is a $2.7 billion increase from the 2021 enacted level.
  • $732 million for funding early intervention services for infants and toddlers with disabilities or delays — services that have a proven record of improving academic and developmental outcomes.
    • The $250 million increase for early intervention services would be paired with reforms to expand access to these services for underserved children, including children of color and children from low-income families.
  • $1 billion in addition to the resources in the American Rescue Plan, to increase the number of counselors, nurses, and mental health professionals in schools.
  • $443 million for Full Service Community Schools. These are schools that provide comprehensive academic, health, and social services for students, their families, and community members, resulting in improved educational outcomes for children.
  • $100 million in new competitive grants to advance racial equity in the child welfare system and reduce unnecessary child removals.
    • The Budget also increases funding for state and local child abuse prevention programs by over 30% compared to the 2021 enacted level.
  • $200 million to:
    • Reduce maternal mortality and morbidity rates nationwide.
    • Bolster Maternal Mortality Review Committees.
    • Expand the Rural Maternity and Obstetrics Management Strategies program.
    • Help cities place early childhood development experts in pediatrician offices with a high percentage of Medicaid and Children’s Health Insurance Program (CHIP) patients..
    • Implement implicit bias training for healthcare providers.
    • Create state pregnancy medical home programs.

State Updates

Nebraska Legislature

The Nebraska Legislature adjourned sine die (Translation: the final adjournment of an annual or the two-year session of a Congress.) on Thursday, May 27.

Liz Lyons at Children’s is individually reaching out to departments and leaders to notify them of effective dates of every bill. But as a rule of thumb:

  • Any bill that comes with an emergency clause becomes law as soon as it is signed by Governor Ricketts.
  • Bills without an emergency clause or other effective date will become law ninety days after Sine Die adjournment.

Based on the May 27th adjournment, the non-emergency bills would become effective in law on August 28, 2021.

Supplemental Nutrition Assistance Program (SNAP) Benefit Bill

Last week, Senator John McCollister’s (R-Dist. 20, Omaha) SNAP benefit bill (LB108) overcame a Gubernatorial veto, meaning the Legislature ultimately voted to approve the bill regardless of opposition from the Governor’s office. LB108 expands SNAP eligibility to families up to 165% of the Federal Poverty Level ($43,000 for a family of four), up from the previous limit of 130% of the Federal Poverty Level. This bill had an emergency clause, so it will be effective immediately.

Next Year’s Priorities

Now that session is over, senators are back home in their districts and working with stakeholders to determine next year’s priorities. Given that there is nearly $1 billion in one-time federal funding available for next year, the clock has started for many to collect information to advance their priorities.

One way to gather stakeholders in a formal hearing process is through interim studies, which typically have hearings late summer through winter. A full list of interim studies introduced can be found here.

Some of the interim studies Children’s is specifically interested in include:

  • LR101 (Sen. Williams): Examine whether legislation should be enacted to provide for comprehensive regulation of pharmacy benefit managers
  • LR139 (Sen. M. Hansen): Examine the financial health of individuals in Nebraska’s workforce over one year into the COVID-19 pandemic
  • LR142 (Sen. M. Cavanaugh): Determine whether legislation should be enacted to provide for additional supports and further address the issue of maternal depression in Nebraska
  • LR143 (Sen. Stinner): Examine the mental and behavioral health needs of Nebraskans, assess the shortages of providers, and determine what is needed to ensure an adequate behavioral health service delivery system
  • LR145 (Sen. Stinner): Study the adequacy of current aged and disabled Medicaid waiver assisted living provider rates
  • LR148 (Sen. Day): Examine the duties of education support professionals in Nebraska
  • LR149 (Sen. Day): Examine the potential for statewide early childhood autism spectrum disorder screening
  • LR163 (Sen. Stinner): Examine post-acute placement challenges in Nebraska’s healthcare system
  • LR180 (Sen. Walz): Examine the identification of at-risk and economically disadvantaged students as a qualification factor for state-funded, education-related programs
  • LR184 (Sen. Wishart): Examine the contract process and rates paid to family service providers in the Northern, Southeast, Central, and Western Service Areas of Nebraska
  • LR193 (Sen. DeBoer): Examine broadband mapping and broadband speed testing in Nebraska
  • LR200 (Health and Human Services Committee & Appropriations): Examine the long-term fiscal sustainability of the Nebraska Health Care Cash Fund
  • LR201 (Health and Human Services Committee Health and Human Services): Examine issues within the jurisdiction of the Health and Human Services Committee
  • LR202 (Health and Human Services CommitteeHealth and Human Services): Examine federal legislation regarding COVID-19 pandemic assistance
  • LR203 (Sen. Flood): Examine Medicaid expansion and behavioral health
  • LR212 (Sen. McDonnell): Examine the healthcare workforce shortage in Nebraska
  • LR213 (Sen. Day): Examine the mental and behavioral health needs of Nebraska students and the role of school psychologists
  • LR221 (Sen. Vargas): Examine maternal and infant mortality and morbidity
  • LR226 (Sen. M. Cavanaugh): Examine ways the Legislature provides oversight of state agencies
  • LR237 (Sen. Vargas): Examine existing statutes regarding directed health measures
  • LR239 (Health and Human Services Committee): Examine the effectiveness of Medicaid waivers in Nebraska overseen by the Department of Health and Human Services

Nebraska Department of Health and Human Services (DHHS)

A new proposed rule from Nebraska DHHS aimed at reaching compliance with federal guidelines has created concerns among child care providers in the state.

During the DHHS hearing last week, child care providers discussed how the new ratio requirements, coupled with the limitation of number of children per room, could generate an access issue for child care services in the state. It is unknown how the Department will respond following the hearing.

Children’s will continue to track the proposal and others that have hearings this summer.

(Sources:CHA,The Hill,White House,Congress.gov,NHA,DHHS,Nebraskalegislature.gov, Peetz & Co.)

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