Deficit Reduction Act (DRA)

On March 31, 2006, HHS Secretary Michael Leavitt outlined new flexibilities available to states under the Deficit Reduction Act (DRA) of 2005 (Pub.L. No. 109-171). Find out how the new DRA provisions may link with other options available under Medicaid to transform long-term care to person-centered care and to expand coverage for individuals with disabilities, increase access to community supports, and promote personal responsibility, independence, and choice.

HCBS.org News CLIPS highlights the important work of Real Choice Systems Change Grantees. In this issue, we have interviewed Dawn Lambert in Connecticut to discuss the key strengths and challenges faced during program implementation of their Nursing Facility Transitions to Independent Living Program. Find out the program basics, success strategies, stakeholder involvement techniques and the options for sustainability.

This report provides a comparison of Medicare, Medicaid and State Child Health Insurance Program provisions contained in the Deficit Reduction Act of 2005 (S. 1932) as amended and passed by the Senate. The report compares the bill's provisions with current law. This report will be updated. The sections that most pertain to providers of HCBS services are the Cash & Counseling section, the HCBS State Plan Option and the Money Follows the Person Demonstration.

With the recent enactment of the Deficit Reduction Act, states who are interested in increasing their home and community based programs have three new opportunities. The DRA has many components but the three provisions that increase flexibility over benefits and cost sharing include the Home and Community-Based Services (HCBS) option (section 6086-page 118), a Money Follows the Person (MFP) demonstration project (section 6071-page 99)and a Cash and Counseling option (section 6087-page 124).

This issue brief summarizes the Medicaid provisions of the budget reconciliation law signed in February 2006 and discusses the implications of the proposed changes. The changes would net reductions of $4.8 billion over the next five years and $26.1 billion over the next ten years from current Medicaid spending. Read about the many policy changes in the DRA, which both reduces federal and state Medicaid spending and also changes health care access and coverage for low-income beneficiaries.