AMCHP Policy Team: Looking Back on 2010
By Brent Ewig, MHS
Director of Public Policy & Government Affairs, AMCHP
As the clock winds down on 2010 here in our nation’s capital it is appropriate to take a look back on the year in MCH policy – and what a year it was! AMCHP’s 2010 Policy Agenda was dominated by two main issues – the Budget and the Affordable Care Act. Although the debate over both is far from over, it seems clear that in years ahead we will look back upon 2010 as a major turning point in the evolution of health policy in the Unites States.
This has been an extraordinary year in MCH policy with some tremendous wins for Title V – most specifically inclusion within the Affordable Care Act of close to $1.9 billion in new mandatory Title V funding over five years for the new Home Visiting and Personal Responsibility and Education grant programs!
On the other hand, we’ve seen a dramatic shift regarding deficit politics punctuated in the recent elections and exemplified by the fact that we are closing the year without final resolution of the FY 2011 budget. We now face the reality that FY 2011 budget decisions will remain unfinished until at least March 2012, with the overarching need for deficit reduction putting Title V and many other health programs into a period of clear jeopardy. The impact of the deficit on future allocations to the core Title V MCH Services Block Grant will certainly be a challenge, and AMCHP is gearing up now to adapt our advocacy to this radically new environment.
But the banner headline news of 2010 really is that the passage of the Affordable Care Act creates both tremendous opportunities and challenges for state MCH programs. On December 16, we convened a teleconference for all AMCHP members to review the year in MCH policy and look at what’s in store for 2011. A recording of that call is now posted here, and the following are some of the highlights:
We started the year on a high note with a vote of confidence in the president’s budget which proposed an $11 million increase for Title V. We then built and maintained enough advocacy drumbeat to have the increase included in the Senate Appropriations bill. Key actions included development of AMCHP Title V advocacy materials, including:
· AMCHP’s Title V Appropriations Fact Sheet which describes the function and effectiveness of the MCH block grant and makes the case for increased investment.
· An analysis of the president’s proposed 2011 budget with a chart detailing proposed funding for programs affecting women and children. It was distributed to all members and posted to the AMCHP website.
· State profiles updated for 2011 – including new section on Title V grantees in each state. We distributed these in each of our meeting on the Hill, and members, partners, and families are encouraged to bring state specific information on their Hill visits.
· Testimony in support of state Title V programs to the House and Senate Labor HHS Subcommittees
· Continued strategic dissemination of the Power of Prevention report which provides examples of effective MCH interventions supported by the Title V MCH block grant and makes the case for increasing prevention investments in health reform.
· Finally, over the past year we issued 10 Legislative Alerts urging members to contact Congress in support of full funding for the Title V MCH Block Grant and other key health programs. These action alerts were further disseminated via NACCHO’s newsletter, the APHA MCH Section Newsletter, and Healthy Mothers Healthy Babies Monday Morning Memo.
The centerpiece of our advocacy was conducting 52 meetings with key staff of members serving on the Senate and House Appropriations Committees. These meetings provided us the opportunity to educate policymakers on the importance of the Title V MCH Block Grant and to seek a commitment of support. We also supported close to 60 additional Hill visits during the 2010 AMCHP Annual Conference and sponsored a widely attended Congressional Reception to honor our 2010 Legislative Champion award winners and provide an opportunity for members to mingle with key Congressional staff and hear directly from a few key members of Congress.
Throughout the year we worked to keep the membership and key stakeholders up to date on policy developments via nine national teleconferences, bi-weekly updates published in Member Briefs, monthly columns in Pulse and an up to date Advocacy webpage.
We also worked to increase Title V visibility by representing AMCHP at meetings with White House officials on Title V Appropriations, home visiting, and the Let’s Move campaign development, and represented AMCHP at relevant Hill briefings including maternal mortality, prematurity and infant mortality.
Despite this advocacy, in the end of 2010 it appears the proposed Title V increase is likely to fall victim to Congressional dysfunction and deficit politics, with final decisions now postponed by the current Continuing Resolution lasting until March 2011.
On the health reform front, we began the year with some uncertainty about whether a bill would pass, saw history made with passage in March 2010, and spent the spring and summer scrambling to help members take advantage of immediate opportunities (i.e. home visiting, PREP, etc). As fall approached, we saw a crystallization of the ongoing politics around repealing or blocking implementation, and ended the year again with some uncertainty caused by recent judicial action that ruled the individual mandate to be unconstitutional. While it’s critical to note that judge did not issue an injunction on implementation, and everyone expects the issue to be ultimately settled by the Supreme Court. We expect state implementation will proceed but amidst this uncertainty and with relative certainty that the federal structure will be intact for at least two years.
On the judicial front, we’ll continue to watch, report and respect that process and expect final word from the Supreme Court hopefully within two years.
A Look Ahead: Policy in 2011
Looking to 2011, the AMCHP Legislative and Health Care Finance Committee is finalizing our Policy Agenda now and guiding us to adapt our message to focus on investment and economic arguments. We will redouble advocacy efforts in both offense and defense. On health reform implementation, we want to make the AMCHP National Health Reform Implementation Center your go to source for information, strategies and support.
In closing I want to stress how seriously we take our mission to support state MCH programs and provide national leadership on issues affecting women and children. That grounding gives me confidence that we will meet the unprecedented challenges we face in the next year with the perhaps unwarranted optimism that has always sustained those of us working in public health against tough odds. Make no mistake that we face huge challenges, but we pledge to you that we will do everything we can to make the case for sustained funding, try to minimize the harm of austere budget on the populations we serve, and help us collectively stand together as MCH professionals so we can get to the brighter days that are no doubt ahead.