Communication letter Category: Comments & Statements

Lutheran Services in America submitted comments urging CMS to reconsider establishing mandatory minimum staffing requirements at SNFs in order to protect access to care for older adults.

As the United States Supreme Court deliberates the California v. Texas and Texas v. California lawsuits which could fully overturn the Affordable Care Act (ACA), Lutheran Services in America President and CEO Charlotte Haberaecker emphasizes the national network’s support for ensuring that all Americans have access to affordable, quality health care – regardless of their income, race, gender, faith or ZIP code.

“While the ACA is not perfect, the protections it has instituted for underserved groups have greatly increased their ability to access much-needed health care especially important during the ongoing COVID-19 public health emergency. At this vital time, given our longtime commitment as a faith-based organization to meeting the health and human services needs of all people, we urge Congress and the Administration to safeguard in federal law protections for these populations throughout America.

“Every day, Lutheran Services in America’s 300 health and human service member organizations serve one in 50 Americans ranging from older adults and children, youth and families, to people with disabilities, veterans and people of all ages experiencing homelessness. All of these populations are better served by legal provisions that make obtaining and maintaining quality, accessible and equitable health care coverage easier – including the elimination of pre-existing condition exclusions, Medicaid coverage expansion, and the prohibition of discrimination based on health status.”

Haberaecker added that complete repeal of the existing law would mean loss of access to high-quality, affordable health care for populations served by Lutheran Services in America’s members in the following ways:

• Almost 13 million low-income adults who became newly eligible for Medicaid under the ACA would lose their health insurance and access to treatment for chronic conditions, mental illness, and substance use disorders.
• Up to 133 million people with pre-existing health conditions — 51 percent of all Americans — could become uninsurable.
• About 1.5 million children would lose Medicaid coverage based on changes to eligibility rules, as would people aged 19 to 26 formerly in foster care.
• State options to provide some new types of community-based, long-term care for nearly 500,000 seniors and people with disabilities would end, potentially causing those beneficiaries to return to institutions for care.
• States would lose the ability to conduct Medicaid eligibility determinations using new, streamlined processes, presenting a challenge given the technological changes they’ve made to comply with the new ACA rules.

For further information, contact Christopher Findlay at (202) 499-5833 or cfindlay@lutheranservices.org, or Sarah Dobson at (202) 499-5832 or sdobson@lutheranservices.org.

Following the decision of the United States Supreme Court to dismiss the California v. Texas lawsuit which could have fully overturned the Affordable Care Act (ACA), Lutheran Services in America President and CEO Charlotte Haberaecker emphasizes the national network’s support for ensuring that all Americans have access to affordable, quality health care – regardless of their income, race, gender, faith or ZIP code.

“While the ACA is not perfect, the protections it has instituted for underserved groups have greatly increased their ability to access much-needed health care especially important during the ongoing COVID-19 public health emergency. At this vital time, given our longtime commitment as a faith-based organization to meeting the health and human services needs of all people, we are pleased to see protections for these populations preserved in federal law.

“Every day, Lutheran Services in America’s 300 health and human services member organizations serve one in 50 Americans ranging from older adults and children, youth and families, to people with disabilities, veterans, and people of all ages experiencing homelessness. All of these people are better served by legal provisions that make obtaining and maintaining quality, accessible, and equitable health care coverage easier – including Medicaid coverage expansion, the elimination of pre-existing condition exclusions, and the prohibition of discrimination based on health status. We encourage lawmakers and the Administration to commit to doing even more to protect the health of all Americans.”

For further information, contact Christopher Findlay at (202) 499-5833 or cfindlay@lutheranservices.org, or Sarah Dobson at (202) 499-5832 or sdobson@lutheranservices.org.

Urging the Department not to approve the harmful proposal, which includes per capita caps and work requirements, among other detrimental elements.
**UPDATE: On August 11, following a successful state ballot initiative in June to add Medicaid expansion under the Affordable Care Act to the state constitution, the Oklahoma state Medicaid director asked to withdraw the state’s waiver proposal.

From Charlotte Haberaecker, President and CEO of Lutheran Services in America

On behalf of the one in 50 Americans who rely on the 300 Lutheran health and human services providers throughout the United States that comprise Lutheran Services in America, thank you for considering our statement at this important time. With our active presence in over 1,400 communities in 45 states as seen on this map, our work is critically important in improving the lives of America’s most vulnerable people, ranging from seniors, veterans, and people with disabilities to children, youth and families, and the homeless.

The COVID-19 pandemic dramatically affects all of the people we serve and services we provide. Our 300 health and human service organizations are on the front lines caring for people while taking extraordinary steps to protect their staff and people served. Yet they increasingly struggle with equipment shortages, especially personal protective equipment; severe workforce shortages necessitating hazard pay; declining revenue; and the need to reduce or eliminate needed services. These severe challenges are occurring while our organizations simultaneously face limited cash reserves, decreasing revenue and already-tight margins.

Our work is deeply embedded in communities across the country where we have provided services for over 150 years. Yet our work—which comprises a significant part of the health and human services delivery system—cannot continue without specific measures taken soon to support nonprofit health and human service organizations. Without needed resources to support our work during this time of crisis, we will be unable to meet the increasing needs of individuals and communities at their most vulnerable time. One specific resource that is direly needed is an increase in the federal unemployment insurance reimbursement for self-funded nonprofits (also known as “reimbursing employers”) to 100% of costs.

Since 1972 when nonprofit organizations were required to provide unemployment benefits to their employees for the first time, 501c3 charitable nonprofits were given the option to opt out of the State Unemployment Tax system and have been permitted by Congress to self-insure claims for unemployment benefits by paying back the state unemployment trust fund for benefits paid to their former employees. These “reimbursing employers” include nonprofits, state and local governments, and federally recognized Indian Tribes that follow the law by electing to make payments in lieu of contributions to state unemployment trust funds.

As currently enacted into law, Section 2103 of the CARES Act provides that the federal government will cover 50 percent of the cost of claims charged to these reimbursing employers.  This will subject self-funded nonprofits throughout the country to crippling payments to their state unemployment systems later this year, while other employers will likely experience little or no additional costs resulting from mass COVID-19-related layoffs. The impacts will be real. Many nonprofits will be hit with a bill for reimbursement to states at a time when the demand for services is highest.

Seventy-five percent of payroll costs in the nonprofit sector are paid out by “reimbursing employers.”  Together, these organizations provide much of the infrastructure that we rely on to serve people in all our communities. Addressing this issue by providing 100% reimbursement for these nonprofits will help ensure that they will be able to better direct their limited resources to serving vulnerable people through the care and services they provide every day.