Join us for the Legislative Update call on
Tuesday, Nov. 13, at 1 p.m. (ET)
APHA's legislative staff will provide an update on
congressional activity and Q & A
Call (800) 442-5794
I. Election results and impact on APHA priorities
II. Deficit reduction to top lame duck agenda
III. APHA urges Senate to support disability treaty
IV. Policy watch: State and international updates
Election results and impact on APHA priorities
On Tuesday, Barack Obama was re-elected president of the United States, winning at least 303 electoral votes, more than the 270 required to be elected. His Republican challenger, former Massachusetts governor Mitt Romney, won 206 electoral votes. While the Florida’s 29 electoral votes remain undecided at the time of this update, the ultimate outcome in Florida will not change the result of the election. In the U.S. Senate, Democrats picked up two seats, putting them in control of 53 seats in the chamber, while Senate Republicans will control 45 seats. In addition, two independents were elected to the Senate. Sen. Bernie Sanders, I-Vt., caucuses with, or generally votes with the Democrats and newly elected Sen. Angus King, I-Maine, is also expected to caucus with the Democrats. In the House of Representatives, Democrats picked up a few seats and a number of races remain undecided, but Republicans will retain control of the chamber.
The election results will have a major impact on several of APHA’s top priorities. The first example is the Affordable Care Act, which is strongly supported by APHA. President Obama and the Democratic majority in the Senate also favor maintaining the law. It is unclear whether the House Republican leadership will continue to bring bills to repeal the ACA to the House floor now that President Obama has been re-elected and Senate Democrats have expanded their majority. In addition, ongoing legal challenges to the ACA and opposition to the law’s Medicaid expansion provisions by governors in several states will continue to present a challenge to supporters of the law.
The results will also likely boost the U.S. Environmental Protection Agency’s efforts to regulate pollution from coal- and oil-fired power plants, cross state air pollution and greenhouse gases under key public health rules required under the Clean Air Act. Opponents of the EPA rules tried to link the loss of jobs and the sluggish economy with regulation of power plants and coal-related pollution during the 2012 campaign.
Efforts to address the so-called fiscal cliff will also be affected by the results. The fiscal cliff refers to $7 trillion in expiring tax cuts and required spending cuts over the next decade. Due to the failure of Congress to come up with a deficit reduction plan 2011, automatic spending cuts (also known as the sequester) of roughly 8.2 percent to both defense and nondefense discretionary programs is set to kick in beginning in January (more detail in the story below). Such cuts would have a devastating impact on many public health programs including various provisions in the law, such as the Prevention and Public Health Fund. Members of both parties have stated they would like to find a way to prevent the sequester from taking effect. A major sticking point in negotiations to avert the sequester has been the issue of replacing it with a package that would include new revenue by letting some of the tax cuts for the highest income earners expire. At this point it is unclear whether Congress will take some temporary action to avoid the sequester before the new Congress is sworn in in January. APHA and its members have worked to urge members of Congress to find a balanced approach to deficit reduction that prioritizes public health and avoids sequestration.
Deficit reduction to top lame duck agenda
With the election over, attention will now turn to the lame duck session of Congress, set to start on Nov. 13, when a number of pressing fiscal issues will likely be addressed. One of the key issues that APHA and other public health organizations will focus on is the issue of the looming budget sequestration set to kick in Jan. 2. On Sept. 14, the White House Office of Management and Budget released a report outlining how the across-the-board cuts under sequestration would be implemented. APHA released a statement noting the negative impact the cuts would have on public health programs. The report estimates that across-the-board cuts of roughly 8.2 percent would be required for all nondefense discretionary programs, which includes most public health programs at the Centers for Disease Control and Prevention, Health Resources and Services Administration and other public health agencies. APHA is working with its health partners and other members of the nondefense discretionary community (education, law enforcement, environmental protection, etc.) to urge members of Congress to find a bipartisan and balanced approach to deficit reduction and to avoid the deep cuts to nondefense discretionary programs under sequestration.
APHA has developed a page with resources for advocates to use in their efforts to advocate against sequestration. Several APHA members and affiliates had op-eds and letters to the editor in support of public health funding and opposing the sequester published in local papers during APHA’s annual PHACT Campaign. APHA members are strongly encouraged to continue their efforts to urge their members of Congress to find a balanced approach to deficit reduction that prioritizes public health and avoids sequestration.
APHA urges Senate to support disability treaty
On Oct. 19, APHA sent a letter to Senate Majority Leader Harry Reid, D-Nev., and Senate Minority Leader Mitch McConnell, R-Ky., urging the Senate to support the ratification of the Convention on the Rights of Persons with Disabilities. U.S. ratification of the CRPD is consistent with our nation’s commitment to fully implement and enforce U.S. disability laws and ensure that children and adults with disabilities receive the health care, education, transportation and employment opportunities vital to participate fully in all aspects of life.
The World Report on Disability estimates that there are a billion people worldwide with disabilities. It projects that this number will continue to grow due to the increasing prevalence of HIV/AIDS and non-communicable chronic diseases, the aging of the world's population, more effective lifesaving measures of infants and mothers and increasing numbers of countries in conflict.
Currently, 154 nations and regional integration organizations have signed the treaty, including the U.S., and 124 have ratified the convention. In March 2009, APHA sent a letter to Secretary of State Hillary Clinton in support of the U.S. signing and ratifying the convention. Later in 2009, President Obama signed this important human rights treaty and more recently, the U.S. Senate Foreign Relations Committee held a hearing in which strong bipartisan support was expressed for its ratification. The Senate must approve the package by a two-thirds vote before the president can ratify it.
Policy watch: State and international updates
Dallas County approves health benefits for unmarried partners
On Oct. 30, Dallas County, Texas, approved a domestic partner benefit program that will provide unmarried employees with a stipend to provide health benefits to their partners — either gay or straight — to begin in 2013. The stipend is capped at the amount a married employee’s spouse would receive and is only available to partners without coverage through their own employer. Proof of living together for at least six months is required to obtain benefits and the couple must confirm that the relationship as a domestic partnership. This 3-2 vote comes with a clear divide between Democratic and Republican commissioners’ opinions. Democratic commissioners state the policy falls within the county’s antidiscrimination policy and will help attract and retain talent and embrace diversity, while Republican commissioners argue the policy creates a “special pool of people” receiving benefits.
Iowa Initiative to reduce unintended pregnancies
This year the Iowa Initiative to reduce unintended pregnancies wraps up its program, which provides free and reduced price long-acting reversible contraceptives or LARCs. As part of a five-year demonstration, initiative funds were provided to Title X family planning clinics in Black Hawk, Bremer and Buchanan counties to purchase LARCs, which include intrauterine devices or IUDs and other implant devices. Training was provided to clinical physicians and staff on application of the devices. Preliminary findings from the Bixby Center for Global and Reproductive Health and Philliber Research Associates have shown an 8 percent drop in the rate of unintended pregnancies and a 24 percent drop in pregnancies terminated by abortion from 2006–2011. Prior to the introduction of the Iowa Initiative, state rates of unintended pregnancy for women ages 18 to 30 closely matched trends across the United States, making the initiative a potential model for reducing unintended pregnancy in other counties and states.
APHA signs universal health coverage letter to the World Bank
On Oct. 11, APHA joined 109 other civil society organizations from across the world in sending a letter to the World Bank urging the bank to support universal health coverage on a global scale. The letter calls on the bank to remove out-of-pocket fees, which can block access to health care for the poor, especially women. The letter also urges the bank to take additional steps to help countries achieve universal health coverage by providing support to expand public financing, offering balanced policy advice, ensuring the inclusion of civil society organizations in national health policy development and collaborating with global health institutions.
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