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The Community First Choice (CFC) Option emerged from discussions with Senator Harkin's (D-IA) and Representative Davis' (D-IL) offices in August of 2009 as a way to make progress on home and community-based services and supports under Medicaid and a way to lay the foundation for later enactment of the Community Choice Act. The CFC Option would encourage states to provide home and community based services by providing an increased federal share Medicaid payments. However, if a state chooses the CFC option, they would have to adhere to its higher standards (no caps on services, no waiting lists, and no geographic restrictions.) More......
The Community Choice Act (CCA) of 2009 amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. More ....
Sponsors:
  (D-IA) (D-IL)
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Latest Major Developments
The Community First Choice Option is LAW
March 30, 2010 - President Obama signed into law the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) which contains "fixes" to the health care reform bill (HR 3590). March 25, 2010 - The senate voted to pass the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) which contains "fixes" to the health care reform bill (HR 3590) by a vote of 56 to 43. The House then passed the reconciliation bill for a second time as the Senate had made some technical changes to it by a vote of 220 to 207. March 21, 2010 -
In an historic vote, the House of Representatives voted 219 to 212 to pass the Senate health care reform bill, the Patient Protection and Affordable Health Care Act (H.R. 3590). Thirty four Democrats and all Republicans opposed the bill. The bill is expected to be signed into law by President Obama, possibly as early as tomorrow. The non-partisan Congressional Budget Office estimated that the legislation would cost $940 billion over ten years and reduce the federal deficit by $130 billion over the first ten years and $1.2 trillion in the second ten years. The House then took up a budget reconciliation bill (the Reconciliation Act of 2010 H.R. 4872) to make amendments to the health care reform bill to address issues which were problematic to many Members of Congress. The reconciliation bill was passed by a vote of 220 to 211 and must now go to the Senate for passage. The vote on the House and Senate passed Patient Protection and Affordable Health Care Act was a great victory for the aging and disability community. March 17, 2010 - The next several days will make or break health care reform. As of today, the likely steps are as follows: 1. Late this week, the House will vote to simultaneously approve a reconciliation bill which includes fixes to the Senate bill and “deem” the Senate bill to be passed. Some members want to use the “deem and pass” process to avoid having their votes on the “unfixed” Senate bill used against them in the midterm elections. 2. If the House approves a reconciliation bill and “deems” the Senate bill to be passed, then the Senate will debate and vote on the reconciliation bill. 3. If the Senate passes the reconciliation bill, then President Obama will sign it into law. Week of March 8, 2010 - Work progressed on several fronts toward passage of comprehensive health reform legislation. House and Senate Democratic leaders and the White House made substantial progress on negotiating a reconciliation bill which makes changes to the Senate bill to appease many House Democrats. In addition, the Congressional Budget Office continued to develop its cost estimate on the reconciliation package, and President Obama and other senior Administration officials, Speaker Pelosi (D-CA) and House Majority Whip Jim Clyburn (D-SC) continued to lobby House Democrats to secure the 216 votes necessary to pass the Senate bill. Even though the vote count was not secure at the end of the week, the Speaker tentatively scheduled the vote for the end of this week. The White House announced that the President would postpone a scheduled trip to Asia until March 21 to be available to assist in securing the necessary votes for House passage of the Senate bill. The Senate's health reform bill includes many provisions that are important to the disability community such as:
· Insurance market reforms (e.g. elimination of pre-existing condition exclusions, annual and lifetime caps); · An expansion of Medicaid eligibility to 133% of the federal poverty line with significant federal supports; · The Community Living Assistance Services and Supports (CLASS) Act to create a nationwide voluntary long term services insurance program; · The Community First Choice Medicaid Option to give states increased incentives to provide comprehensive home and community services; and · Several improvements to existing Medicaid home and community-based programs to provide more incentives for non-institutional supports.
Meanwhile in the Senate, Majority Leader Harry Reid (D-NV) and Majority Whip Richard Durbin (D-IL) worked to secure assurances from 51 Senate Democrats that they will vote for the reconciliation bill. House Speaker Pelosi needs these specific assurances to mollify wavering members of the Democratic caucus who fear voting for the Senate bill will hurt them politically because it includes provisions which give special treatment to specific states. Most of those provisions will be removed in the reconciliation bill.
Jan 19, 2010 - Enactment of comprehensive health reform legislation suffered a serious setback with the election of Republican Scott Brown in Massachussetts. Without a 60 vote margin, the Democrats will be hard pressed to secure the votes to stop a filibuster. Senator-Elect Brown has vowed to oppose the health reform bill, depriving Senate Democrats of their filibuster-proof majority. Immediately following the special election, the White House and the Democratic Congressional leadership began deliberations to develop a back-up plan to enact a health reform bill. One of the options, for the House of Representatives to pass the Senate bill, was temporarily nixed when House Speaker Nancy Pelosi, after a meeting with the Democratic Caucus, said that there are not sufficient votes for passing the Senate bill at this time. In several public statements, President Obama pledged to advocate for passage of health reform this year
Dec 24, 2009 - By a 60-39 party line vote, the Senate passed the Patient Protection and Affordable Care Act. As many commentators have noted, reconciling the Senate and House health care reform bills will be the most challenging part of the road to enactment. It is not anticipated that House and Senate Conferees will be formally named until further along in the negotiation process. Dec 21, 2009 - The Senate voted (60-40) to end a Republican filibuster on the manager's amendment to the health care reform bill. Technically, the vote was to "invoke cloture" or end the debate. The Senate will now proceed through two more "cloture" votes before it can vote directly on the revised health reform bill. The next vote is scheduled for 7:00 am on Tuesday on the substitute amendment to the $871 billion health care package. The final cloture vote, on the underlying bill, is scheduled for Wednesday afternoon. This vote will clear the way for a vote on passage of the health reform bill on Christmas Eve night, December 24. There are no signs yet that the Republican leadership will allow any shortcuts to the process. Dec 19, 2009 - Senate Majority Leader Harry Reid (D-NV) and Senator Ben Nelson (D-NE) reached agreement on a package of amendments to the Senate health reform bill. The Congressional Budget Office and the Joint Committee on Taxation released an estimate of the costs of the revised bill indicating that the package of revisions raises the cost of the bill by $10 billion over a decade, but also increases revenues by $12 billion, effectively lowering the deficit by an added $2 billion over the next decade. The revised package also includes an added $10 billion to build community health centers and increase the number of doctors in medically underserved regions, bringing the total cost to $871 billion. Inclusion of language on the CFC Option in the compromise package was a great victory for the disabiliy and aging community. It had been uncertain in the last week as Senate Majority Leader Harry Reid (D-NV) worked to ensure the 60th vote from Senator Ben Nelson (D-NE). Nelson had mentioned the CLASS Act as a concern to him, but in the end, the CLASS Act was kept in.
Nov 30, 2009 - If there are 60 votes in support of the motion to proceed, debate on the Patient Protection and Affordable Care Act is expected to begin on the Senate floor. Senate debate would likely take at least two weeks.
Nov 21, 2009 - The Senate is expected to vote on a motion to proceed on the Patient Protection and Affordable Care Act. Nov 18, 2009 - Senate leadership unveiled its final health reform package, the Patient Protection and Affordable Care Act. This bill is the result of the merger of the Finance and HELP Committee bills. The CFC Option is included in the final Senate bill. Nov 7, 2009 - The House of Representatives passed the Affordable Health Care for America Act (H.R. 3962) by a vote of 220 to 215. This bill includes a statement of support for the Community First Choice Option. Click here to see how your representative voted.
Nov 3, 2009 - The House included a statement of support for the Community First Choice Option in their manager's amendment through a "Sense of the Congress", which indicates that since it is in the Senate bill, the House would like it to be in the final bill merged between the chambers. This is helpful towards inclusion of the CFC Option in a final bill.
Oct 29, 2009 - House Speaker Nancy Pelosi (D-CA) introduced the Affordable Health Care for America Act (H.R. 3962) which reflects the merger of the health reform bills of the three House committees with jurisdiction over health reform. The CFC Option is not included in this bill. However, advocates are working to ensure that it is included in the final House-Senate health care reform bill. Oct 13, 2009 - By a vote of 14-9, the Senate Finance Committee, chaired by Sen. Max Baucus (D-MT), passed the America's Healthy Future Act of 2009. Sen. Olympia Snowe (R-ME) joined all Democratic members in voting for the bill. This is the first expression of bi-partisan support for a health care reform package this year and marks a major step forward in securing passage of comprehensive health reform legislation this year. The Senate Finance Committee bill includes the CFC Option. Aug, 2009 - The Community First Choice (CFC) Option emerged from discussions with Senator Harkin's (D-IA) office and Representative Davis's (D-IL) offices as a way to make progress on home and community-based services and supports under Medicaid and a way to lay the foundation for later enactment of the CCA. The CFC Option would encourage states to provide home and community based services by providing an increased federal share Medicaid payments. However, if a state chooses the CFC option, they would have to adhere to its higher standards (no caps on services, no waiting lists, and no geographic restrictions.) The CFC Option is estimated to cost $6 billion over 10 years. July 17-31, 2009 - The House Tri-Committee (Ways & Means, Energy and Commerce, and Education and Labor) voted to pass the America's Affordable Health Choices Act. July 17, 2009 - By a party ine vote of 13-10, the Senate Health, Education, |
About the Other Critical Long Term Services and Supports Provision in the New Health Care Reform Law |
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The Community First Choice (CFC) Option
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