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 View from Washington

MCH Programs Approaching Critical Crossroads

By Brent Ewig, MHS
Director, Public Policy & Government Affairs, AMCHP

Welcome to fall – the season of pumpkins, the World Series, and every two years the frenzy of congressional elections. Here is a quick overview of where some key MCH issues stand in the 113th Congress.

Federal Funding for Title V and Other Vital MCH Programs: Before adjourning back in September to allow members to hit the campaign trail, Congress passed a continuing resolution (CR) to sustain federal funding for all federal programs through Dec. 11 (for details see the AMCHP Legislative Alert here). Congressional leaders also announced a "lame duck" session to convene the week after elections starting on Nov. 12.

Action on funding levels for the remainder of FY 2015 will certainly be high on the lame duck agenda. Decisions on two other major maternal and child health programs – the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and the Children's Health Insurance Program (CHIP) – are looming as well. Extensions for both of these programs could be addressed in either the lame duck session or early in 2015.

MIECHV was created in 2010 with an initial authorization for five years and $1.5 billion dollars. At that time, AMCHP joined dozens of national organization in advocating for this investment. We continue to highlight how MIECHV is built on decades of growing evidence of the effectiveness of home visiting as a service delivery strategy capable of producing measurable improvements across a range of domains including maternal and child health; childhood injury prevention; school readiness and achievement; crime or domestic violence; family economic self-sufficiency; and coordination with community resources and supports.

Last March, Congress included a six month extension of MIECHV as part of a broader legislative package addressing Medicare physician payment rates, formally known as the Sustainable Growth Rate or SGR. This extension for MIECHV is set to expire Mar. 30, 2015. AMCHP continues to play a leadership role in a broad coalition of stakeholders urging Congress to continue this critical program, highlighting key messages about home visiting being a voluntary, cost-effective, pro-family program that has long enjoyed bipartisan support. Stay tuned for additional updates and action alerts as the timing for Congress to vote on this becomes clearer.

Federal funding for CHIP also is set to expire Sept. 30, 2015. If CHIP funding expires, there will be an estimated two million children who will not qualify for Medicaid nor subsidies to purchase plans on the exchange. Furthermore, there are other consequences even for the children whose families would qualify for subsidies to purchase plans on the exchange as several studies demonstrate that the benefits packages are less robust and that cost sharing is less affordable among plans available on the exchanges as compared to CHIP plans. In order to ensure that children in all states have continued access to robust and affordable coverage, AMCHP is joining with hundreds of organizations to advocate that funding for the CHIP program should be continued.

The following are some background resources related to CHIP. This report by Wakely Consulting Group provides an analysis of CHIP plans compared to qualified health plans available in the exchanges in 35 states. The executive summary does a great job of highlighting the financial impact on families, especially families of children with special health care needs. Additionally, here are state CHIP fact sheets courtesy of the National Academy for State Health Policy along with the American Academy of Pediatrics (AAP) statement on CHIP.

As with MIECHV, stay tuned for AMCHP Legislative Alerts on how you can weigh in with your elected officials on these critical MCH programs, and as always, please let us know what additional information you need and how we can improve our leadership for women, children and families.