Take action on Build Back Better legislation, substance use disorder, etc.
Take action on Build Back Better legislation, substance use disorder, etc.
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October 28, 2021 | Volume 25, No. 10 | Archives
Build Back... Mediocre?
In this Issue:
  • Build Back Better Health Proposals Must Move Forward: A Call to Action!
  • Congress Continues to Punt on Budget, Infrastructure, and Other Priorities
  • Substance Use Disorder Treatment Advocacy
  • New COVID-19 Vaccine Guidance, Crisis Care Plans, and More
  • Local Advocacy Feature—A Win in Miami
  • What We're Reading
  • BONUS: Special Halloween Take Action
Build Back Better Health Proposals Must Move Forward: A Call to Action for the HCH Community!
Congress is working to pass a budget reconciliation bill based on the priorities laid out in Biden’s Build Back Better Framework. This framework is an updated version, released today, and includes drastic cuts to the original framework released earlier this year (see more details below). Advocacy must continue to include the most robust health care expansion provisions possible. Among the many policies under consideration, three major health priorities, outlined below, are still on the table that would dramatically improve health outcomes for people in the HCH Community.
The National Health Care for the Homeless Council calls on Congress to pass the Build Back Better health expansion proposals immediately and calls on the HCH community to take action by calling or writing your Representatives and telling them they must include ALL the proposed health care expansions in any final Build Back Better bill! The health and lives of so many are in the hands of our policymakers, and as Congress debates the finer point of incremental changes, our patients continue to die on the streets. Note: These action alerts include easy-to-use templates and scripts, but we suggest customizing them using our messaging below and stories from your locality.
Talking Points on Health Care Expansions in Build Back Better
TOP LINE MESSAGE: Congress can and must do both the expansions of Medicaid and Medicare. All of the proposed health care expansion policies are greatly needed and long overdue. Cutting the health proposals down and pitting them against each other for inclusion in a final bill is unconscionable when so many U.S. families already lack basic care and the U.S. has a globally shameful health care reputation.
What it would look like: Current proposals in the U.S House’s initial draft legislation phase in vision, hearing, and dental benefits in 2022, 2023, and 2028 (7 years from now!), respectively. Biden’s latest Build Back Better Framework released today cuts the expanded benefits down further to just hearing (but updated legislation has not yet been drafted).
Why it matters: Low-income people experience many adverse health outcomes because of limited access to dental, vision, and hearing services and insurance coverage. Not only do dental, hearing, and eye issues create significant barriers to daily functioning, employment, and education, but they often lead to intense physical and emotional distress. Additionally, dental and other sensory issues are an expensive and common cause of ER visits for people experiencing homelessness. Access to more comprehensive services under Medicare would avoid adverse health outcomes, improve health and wellness, and reduce health care expenses.
HCH Dentist Testimony: “Tooth decay and gum disease are preventable, and routine dental exams and hygiene visits are an important part of preventive care. Many of our patients have extensive needs because they lack access to care for prolonged periods across their lifespans. Patients often express that there is nowhere to go and no way to pay for their treatment. They feel punted around and that is inexcusable.” – Parita Patel, DMD, MPH, and Dental Director at Health Care for the Homeless Baltimore

What it would look like: While this provision is not included in the U.S. House’s latest reconciliation bill (and advocacy for inclusion must continue!), a separate piece of legislation introduced by Rep. Jayapal (D-WA) would lower the eligibility age from 65 to 60 and take effect in 2023. Biden’s latest Build Back Better Framework released today does not include this provision.

Why it matters: Lowering the age of Medicare eligibility would give more adults critical access to quality and affordable health care, which is proven more cost-effective than other insurers. In the HCH Community, this policy would benefit the nearly 80,000 patients between the ages of 60-64 served at HCH programs in 2020. Access to the high-quality and low-cost Medicare program would also improve mortality rates, an important issue for people experiencing homelessness who die much younger than their housed counterparts.

HCH Physician Testimony: “Because our patients experiencing homelessness often die in their 50s they never get access to the coverage Medicare offers. Lowering the eligibility age will help more of my patients, who are in desperate need of better coverage, live healthier lives—and hopefully longer lives. This can’t wait.” – Jeffrey Norris, MD, Chief Medical Officer at Father Joe’s Village in San Diego


What it would look like: Current proposals in the U.S House’s initial draft legislation provide tax credits in the marketplace for individuals under the poverty line through 2024 and create a federal lookalike Medicaid program thereafter. Biden’s latest Build Back Better Framework released today includes the marketplace tax credits through 2025, and nothing thereafter.

Why it matters: Medicaid coverage prevents evictions, improves health, and reduces mortality. This policy would improve access to care for more than 120,000 patients in the HCH community who remain uninsured. Overall, 85% of total HCH patients are under the federal poverty line, so should be eligible for Medicaid.

HCH Consumer Testimony: “It’s fundamentally irresponsible for the government to not provide insurance options for everyone. Here in Florida I see how Medicaid saves lives and also how uninsured folks always end up in the ER and in debt. For me, there is no question that a lack of Medicaid expansion makes poverty and homelessness worse.”  – David Peery, JD, NHCHC Board Member and Consumer Advocate in Miami 

Learn more:
Congress Continues to Punt on Budget, Infrastructure, and Other Priorities
As the Biden Administration and Democratic Leadership work to finish up a deal on Build Back Better by the end of the month, other key priorities in Congress remain in flux. A vote on the bipartisan infrastructure bill (text) remains on hold until Build Back Better passes. After failing to meet deadlines on the federal budget this summer, Congress temporarily raised the debt ceiling and pushed their Fiscal Year 2022 budget deadline to December 3—and are still behind on drafting out the numbers.  Meanwhile, promised action on other important issues to the HCH community such as voting rights and mental health/addiction (note this includes the MAT Act—see below) are on the table but have seen no substantive progress. Stay tuned to future Mobilizers for how to Take Action.
Substance Use Disorder Treatment Advocacy
A roundtable discussion with invited guests and HCH staff and patients to discuss barriers to substance-use treatment.
Our advocacy continues for broader changes, such as those included in the MAT Act, which eliminates the X-waiver requirement to prescribe buprenorphine and was recently included in the Bipartisan Addiction and Mental Health Task Force 2021 Legislative Agenda. This work also includes focusing on harm reduction measures and part of that is becoming a Syringe Service Program (SSP). Are you already, or do you want to become, an SSP? If so, we want to talk with you; reach out to set up an informal 15-minute call with kleague@nhchc.org.
As part of our national advocacy, Health Care for the Homeless in Baltimore (HCHMD) hosted a visit and press conference with HHS Secretary Becerra to announce the new HHS Overdose Prevention Strategy. Other participants included Acting ONDCP Director LaBelle, SAMHSA Assistant Secretary Delphin-Rittmon, Baltimore Mayor Scott, Congressman Trone, Maryland Attorney General Frosh, along with providers and patients at HCHMD. Watch the livestream of the press conference (45 minutes) or see the 2-minute local news recap. More pictures and coverage are available on HCHMD's Twitter.
New COVID-19 Vaccine Guidance, Crisis Care Plans, and More
The Biden Administration is quickly rolling out information related to booster shots, and new approvals for COVID-19 vaccines for children ages 5-11.  Learn more about these policy developments and emerging issues related to COVID-19 in the biweekly COVID-19 Flash Blast.
Local Advocacy Feature—A Win in Miami
David Peery speaking at the rally!
This month, a coalition of advocates held a Housing Justice and Homeless Rights Rally outside of Miami City Hall. The rally effectively stopped the Miami City Commission from passing an "anti-camping ordinance" that would empower police to arrest people experiencing homelessness.
David Peery, Consumer Advocate and Board Member of NHCHC, was there to lead the efforts and said: “This is a rare, if not unique, outcome in Miami in which wage earners, the working poor, the unhoused -- not the corporate monied, privileged interests -- stopped a law from being passed. And we achieved this victory because of an intensive two-week pressure campaign involving email blasts to City Commissioners, four editorials and OpEds in the Miami Herald, and behind the scenes meetings with Commissioners, culminated by the rally on the day of the vote.”
What We're Reading
Council staff at the annual staff pumpkin carving party (pre-COVID)
BONUS: SPECIAL HALLOWEEN TAKE ACTION: Submit a haiku to Kaiser Health News by tomorrow, Friday October 29! Join the Council’s policy team in submitting your most creative *spooky* haiku about issues relevant to the HCH community (housing, homelessness, Medicaid, etc). If you submit, please send us a copy at rreed@nhchc.org and we’ll feature it in the next issue.  
Here’s an example from NHCHC’s Barbara DiPietro:
What’s Scary?
Vaccines aren’t scary--
But the hospital sure is!
Let’s ALL get the shot!
Did you receive Mobilizer as a forwarded email or hear about it via social media? Register now to receive our action alerts each month!
Sign Up for Mobilizer
Regina Reed, MPH
Health Policy Manager
National HCH Council
Baltimore, MD
(443) 703-1337 
This publication and all HCH advocacy are funded by dues from Organizational Members of the Council and by private donations. Consider joining the Council to support this work.
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