Author: Aditya Kumar

Senator Manchin made the surprise announcement on Sunday that he could not vote for the Build Back Better Act, which will force a large-scale rewrite of the legislation. 

Despite months of negotiations, Sen. Joe Manchin (D-WV), the moderate Democrat whose vote was seen as key in the evenly divided Senate, announced he would not vote for the Build Back Better Act, citing concern with the roughly $2 trillion price tag and how the legislation would be paid for. While Sen. Manchin’s decision is a significant setback, Democratic leaders and the White House are planning to regroup and have vowed to try and salvage the legislation after the holidays. It is unclear exactly what the next version of the legislation will look like, but a vote on a reformulated package could come as early as January.

Although the legislative path forward is uncertain, the advocacy priorities for Lutheran Services in America remain the same. We will continue to advocate for the inclusion of at least $150 billion for home and community-based services in the next legislative package, as well as key provisions that would help address the acute direct care workforce shortage including:

• $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
• the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

Court Lifts Injunction on OSHA Vaccine Mandate

The Department of Labor’s Occupational Safety and Health Administration can enforce its COVID-19 vaccinate-or-test mandate for employers with 100 or more workers, at least for now, following a ruling by the 6th U.S. Circuit Court of Appeals on Friday lifting an existing nationwide enforcement injunction. The decision was quickly appealed to the U.S. Supreme Court on Saturday morning by 27 Republican state attorneys general, as well as dozens of companies and organizations.

OSHA said it will begin enforcing the rule’s requirements a week later than scheduled: OSHA will not cite employers for not complying with any requirements of the standard before January 10 and will not cite employers for not complying with the standard’s testing requirements before February 9, “so long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard,” the department said, adding that OSHA will work closely with employers to assist them with compliance.

This ruling follows a December 15 decision by the Fifth Circuit Court of Appeals scaling back an injunction on the Centers for Medicare and Medicaid (CMS) mandate that all eligible staff at specified health care facilities that participate in the Medicare and Medicaid programs be fully vaccinated against COVID-19 by January 4, 2022.

Under the new ruling, the injunction remains in place only for those states where judges have directly applied it. These states are: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, Wyoming.

As the major mandates make their way through various court challenges, industry stakeholders and legal experts seem to agree that the best practice for providers is to prepare to meet the final deadlines as court challenges play out.

Senate Delays Consideration of Build Back Better Act, Negotiations Continue

Following Sen. Joe Manchin’s (D-WV) announcement last month that he would not vote for the Build Back Better Act in its current form, Democratic leaders and the White House continue to seek the best path forward for the legislation. Private negotiations are continuing, with Congressional aides saying the legislation will likely not be ready for floor action until February at the earliest. Stakeholders have conceded that the final legislation will be changed and likely pared back in its final form. However, given Sen. Manchin’s public support for the $150 billion for permanent funding for home- and community-based services (HCBS) currently included in the package, it seems likely that it could be included in a future bill.

Lutheran Services in America will continue to advocate for the inclusion of at least that $150 billion for HCBS in the package, as well as key provisions that would help address the acute direct care workforce shortage including:

• $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
• the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

We also continue to urge Senators to remove provisions which would worsen workforce shortages:

• An unfunded mandate increasing the amount of time a Registered Nurse must be on duty at a Skilled Nursing Facility (SNF) from 8 hours per day to 24 hours.
• A requirement that the Department of Health and Human Services conduct a study on establishing certain minimum staff to resident ratios in SNFs and to mandate the implementation of the study’s recommendations without providing additional funding for providers.

Join us in advocating for these issues.

Supreme Court Blocks Biden Administration’s Workplace Vaccine Rule

The Supreme Court blocked enforcement of the Biden administration’s Covid-19 vaccine-or-test mandate for workers at large businesses but allowed enforcement of a similar mandate for certain health care workers. While challenges to the mandates from businesses and Republican-led states were returned to lower courts, the ruling suggests that the justices are likely to rule against the business rule if the case reaches the court again, but would look more favorably on the mandate for health care workers.

By Sarah Dobson, Senior Director of Public Policy and Advocacy, and Josh Dubensky, Director of Public Policy and Advocacy for the Lutheran Services in America Disability Network

The Senate barreled towards an ultimately unsuccessful showdown on voting rights legislation while the House focused on reviving Build Back Better.

Democrats tried and ultimately failed Wednesday to change Senate rules and bypass a Republican filibuster to pass a voting rights bill with only 50 votes.  While the high-profile push was playing out in the Senate, House Democratic leaders were working to revive President Biden’s Build Back Better legislation. Sen. Manchin’s decision late last year to oppose the measure due largely to its $2 trillion price tag was a significant setback, but work has continued behind the scenes to find a path forward. There are few details about what the potential new package will look like, other than it will likely be smaller than the version passed by the House late last year.

Although the legislative path forward is uncertain, the advocacy priorities for Lutheran Services in America remain the same. We will continue to advocate for the inclusion of at least $150 billion for home and community-based services in the next legislative package, as well as key provisions that would help address the acute direct care workforce shortage including:

• $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
• The provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

Negotiations on a revised Build Back Better Act remain behind closed doors as Congress publicly debates several high-profile issues. The replacement of Supreme Court Justice Stephen Breyer and the crisis in Ukraine have garnered the most media attention, but another government spending deadline is fast approaching. Congress has until February 18 to reach a deal or face a shutdown, but disagreements over a top-line spending number and controversial amendments have made finding an agreement difficult.

Behind the scenes, Democratic leaders are still working to win over moderate holdouts to President Biden’s Build Back Better plan. Sen. Joe Manchin, whose opposition to the almost $2 trillion price tag scuttled the original legislation in December, reiterated on Tuesday that the current version is “dead.” However, he is open to negotiations on a smaller package, and it appears that he is supportive of including $150 billion for home and community-services. The size of the package and details of what else could be included remain uncertain.

As negotiations continue, the advocacy priorities for Lutheran Services in America remain the same. We will continue to advocate for the inclusion of at least $150 billion for home and community-based services in the next legislative package, as well as key provisions that would help address the acute direct care workforce shortage including:

• $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
• The provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

Join us in our efforts to ensure these provisions are included as negotiations move forward.