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 Legislative Corner

Get up to Date on Federal MCH Policy
The next even in the All-Member National MCH Policy Call series will take place on Nov 2 from 2-3:30 p.m. ET.

ACA Open Enrollment Season Begins Next Week
Affordable Care Act (ACA) open enrollment season begins on Nov.1 and ends Dec. 15.  Major features of the 2018 season are as follows:

  • Without congressional action, low-income enrollees in Marketplace plans will no longer receive cost‐sharing reductions (CSRs). Fifty-eight percent of people currently enrolled in ACA marketplace plans receive CSRs to reduce the cost of coverage.
  • Federal funding for marketing has been reduced by 90 percent, and in‐person enrollment assistance has been reduced by about 42 percent. 
  • Uncertainty about the ACA has contributed to Marketplace exit by some insurance companies. In 2017, there were, on average, 4.3 issuers per state.  In 2018, there are, on average, 3.5 issuers per state.
  • In the past, consumers who were automatically re-enrolled in Marketplace plans were sent notices before the end of open enrollment, encouraging them to explore plan offerings in their states, to determine if they could find better or more affordable coverage. In the 2018 open enrollment season, those who are enrolled in ACA Marketplace coverage will be automatically re-enrolled in their existing plan on the last day of open enrollment. Current enrollees may not have an opportunity to explore other plan options, leaving them vulnerable to major premium increases in their plans.

Competing ACA Stabilization Plans

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) introduced a bill to restore CSRs in exchange for greater flexibility in "state 1332" waivers. Senate Finance Committee Chairman Orrin Hatch (R-Utah) and House Ways and Means Committee Chairman Kevin Brady (R-Texas) have introduced a bill that would restore the CSRs while also temporarily halting the coverage mandate – (i.e., the requirement that individuals have health insurance and employers (with over 50 FTEs) – offer coverage to their workers or face a penalty. The penalty for individuals would be halted from 2017 through 2021, while the penalty for employers would retroactive, suspended from 2015 through this year.

CHIP and Extenders to be Voted on in House
The House of Representatives will vote this week on legislation on extending CHIP for five years and extending a number of health programs such as Community Health Centers, PREP, Family to Family Information Centers, and National Health Service Corps for two years. House Republicans and Democrats had been negotiating to find bipartisan offsets to pay for these programs, but the negotiations were unsuccessful. Unfortunately, one of the offsets being used is a cut to the Prevention and Public Health Fund, which is an offset AMCHP is on record opposing. Please see this letter we sent to the House Energy and Commerce Committee earlier this month expressing our opposition.  

Update on MIECHV
In addition to a bipartisan stand-alone, five-year MIECHV reauthorization bill introduced in the Senate (see this letter of support signed by AMCHP, ASTHO and Safe States Alliance), there is now a draft bill circulating in the Senate which would reauthorize several health programs, including MIECHV, for two years. AMCHP is joining the Home Visiting Coalition to thank senators for their inclusion of MIECHV reauthorization as part of any moving legislative package, but we are reiterating support for a five-year reauthorization in order to ensure the program can maximize the number of families who can be served. Please continue reaching out to your senators to ask them to advance S.1829, the five-year version of MIECHV reauthorization!