Push for Health Care Overhaul Continues

NASW strongly supported the U.S. House passing the Affordable Health Care for America Act., H.R. 3962, in November, which included a Medicare provision allowing clinical social workers to bill independently for serving certain nursing home residents.

In an alert sent to members Nov. 10, NASW Executive Director Elizabeth J. Clark noted that she sent a letter on behalf of the association to House Majority Leader Nancy Pelosi, D-Calif., commending Pelosi and her colleagues for introducing H.R. 3962.

Clark explained that professional social workers have a broad perspective on the range of physical, social, emotional, and environmental factors that impact the well-being of individuals, families and communities.

"NASW and its members are longtime advocates for major health care reform," the letter stated. "We have carried the vision of former Secretary of Labor Frances Perkins, a pioneer in the social work profession, who included universal health care on the 12-item agenda she brought to President Roosevelt. This was the only item on her agenda that did not pass into law and social workers have actively sought health care reform since that time."

Clark stated that H.R. 3962 is "an excellent example of what can be accomplished when members of Congress work together to do what is best for the people they represent."

Aspects of the bill that NASW supports include:

  • Extension of coverage to approximately 36 million Americans largely through health insurance market reforms and expansion of Medicaid eligibility;
  • Inclusion of addiction and mental health care in the minimum benefits package, in addition to applying the Wellstone Domenici parity law standard to all qualified health plans;
  • Recognition that fundamental system reforms, such as making improvements to better coordinate care, are necessary to the success of broader health system reforms;
  • Extension for two years of the restoration of rate cuts in Medicare outpatient psychotherapy services, which will help maintain the viability of the Medicare outpatient mental health benefit;
  • Authorization of Medicare payments for clinical social workers to bill independently for services to certain beneficiaries staying in skilled nursing facilities, helping these residents to obtain badly needed mental health services;
  • Increased Medicaid eligibility to 150 percent of the federal poverty level, thereby extending coverage to millions of residents who are currently uninsured, among them childless single adults;
  • Begins to address health professions workforce concerns;
  • Addresses health inequities and seeks to reduce and eliminate health and health care disparities;
  • Inclusion of prevention and wellness initiatives designed to keep Americans healthy; and
  • Inclusion of essential health insurance reforms such as eliminating coverage denials based on pre-existing conditions.

However, NASW was disappointed to learn of the inclusion of an amendment to limit reproductive health services in the bill, said James Finley, NASW lobbyist. He noted that the association will continue to advocate for comprehensive reproductive health services for men and women.

At this story's deadline in November, the U.S. Senate version of a health care reform bill had not yet reached the floor, Finley said. While the Senate works on its bill, the association will continue to push for change in health disparities, workforce needs, Medicare coverage policies that affect social workers and economic protections for low- to moderate-income consumers, Finley said.

On a related note, NASW signed onto a Mental Health Liaison Group letter sent to the Senate and House subcommittees on Labor, Health and Human Services and Education appropriations on Oct. 29.

The letter encouraged lawmakers to generate a conference report of the fiscal year 2010 Labor-HHS-Education appropriations bills and to include the House-passed funding levels for mental health services, support and research.

"The higher funding levels provided in the House bill are essential in meeting the extraordinary mental health needs of communities throughout the nation," the letter stated.

The coalition urged funding increases for overlooked mental health programs in order to boost support for block grants and consumer-centered programs. The letter cited a recent national survey that showed the economic downturn is taking a toll on the mental health of Americans.

"Individuals who are unemployed are four times as likely as those with jobs to report symptoms consistent with severe mental illness," the letter stated. "Americans who experienced involuntary changes in their employment status, such as pay cuts or reduced hours, also are twice as likely to have these symptoms, even though they are employed full time."