Legislative & Policy Corner

They’re BAAAACK!
The election is over, the turkey is eaten and now Congress returns for what is shaping up to be an extremely busy lame duck session. As of Nov. 30, progress to address the fiscal cliff has reached a standstill. Despite this, AMCHP is hopeful that a framework will be released soon. We will be closely monitoring the overall level of funding that is available for discretionary spending, changes to the Affordable Care Act and Medicaid in any deal that is released. It is widely expected that this deal will receive an up or down vote and will not be subject to any amendments by members of Congress.

Additionally, rumors are circulating that members of Congress have begun to cobble together an omnibus appropriations bill providing funding for the federal government for the remainder of the fiscal year. As a reminder, the federal government is currently operating under a continuing resolution providing essentially level funding for programs through Mar. 27, 2013. This omnibus package would provide funding from Mar. 27, 2013 through Oct. 1, 2013. AMCHP sent a letter to members of the House and Senate Appropriations Committees encouraging them to provide $640 million for the Title V Maternal and Child Health Services Block Grant.

Maternal and Child Health Special Order Hour
On Nov. 28, as a result of the leadership of the Friends of Maternal and Child Health Coalition, congressional leaders spoke out yesterday about the negative effects sequestration will have on MCH programs. Click here to view the segment and fast forward to the time 1:32:50 to view Rep. Schakowsky and other member's statements. Title V is specifically mentioned! This is the culmination of months of work completed by AMCHP, American Congress of Obstetricians and Gynecologists (ACOG), American Academy of Pediatrics (AAP), March of Dimes and the National WIC Association.

The Friends of MCH are currently working to get Senators on the floor as well. We still do not know if the cliff or sequestration will be averted, but we continue to advocate for a balanced approach that does not further cut non defense discretionary programs.

PREEMIE Act (S.1440)
Before Thanksgiving break the Senate approved the PREEMIE Act (S. 1440) that authorizes funding to expand research, education and intervention activities related to preterm birth and infant mortality. Importantly this legislation also codifies the existing Secretary’s Advisory Committee on Infant Mortality. The legislation requires that within one year of enactment of the law the committee produce a plan that does the following:

A.     Examine research and educational activities that receive federal funding in order to enable the plan to provide informed recommendations to reduce preterm birth and address racial and ethnic disparities in preterm birth rates

B.     Identify research gaps and opportunities to implement evidence-based strategies to reduce preterm birth rates among the programs and activities of the U.S. Department of Health and Human Services (HHS) regarding preterm birth, including opportunities to minimize duplication

C.     Reflect input from a broad range of scientists, patients, and advocacy groups, as appropriate

The March of Dimes is leading the advocacy effort on this legislation and AMCHP is on record in support of the bill. Before the legislation is signed into law the House of Representatives must approve the bill before the end of this session.

Congressional Hearing on Autism
On Nov. 29, the House Oversight and Government Reform Committee held a hearing entitled, “The Federal Response to the Rising Rates of Autism.”  During this hearing congressional members pledged commitment to continue to provide oversight regarding the federal government role in combating autism. The hearing discussion focused on the extraordinary number of children and young adults living with autism and what is being done to offer supports and services to them and their families. In addition, the hearing focused on members of Congress purporting that there is a link between vaccines and the increasing rates in autism. In the future, the committee intends to conduct hearings examining drug interactions, including vaccines and its impact on development. One of the members of Congress also suggested that Congress fund a study to determine the degree to which autism is connected to mercury releasing sources. AMCHP will continue to monitor these developments. Click here to view an archive of the hearing.

HHS Releases Three New Affordable Care Act Regulations
Timing of the release of highly anticipated rules related to the Affordable Care Act is anyone’s guess, but many are expected in the coming days, weeks and months. On Nov. 20, HHS issued three highly anticipated proposed rules on the Affordable Care Act. The rules cover aspects of the health insurance market and rate review, standards related to essential health benefits, and wellness programs.

Here is a fact sheet for the essential health benefits proposed rule and the fact sheet on the proposed rule on market reforms.

The rules pertinent to the MCH populations are those regarding essential health benefits and the market reforms. Briefly, the essential health benefits proposed rule does not drift far from the guidance provided to states on the selection of a benchmark insurance plan, but provides further detail on the habilitation benefits. The proposed rule on market reforms provides guidance on “key provisions of the Affordable Care Act to prevent insurance companies from discriminating against people with pre-existing conditions and protect consumers from the worst insurance company abuses.” AMCHP is currently analyzing the rules and will provide more information in upcoming Member Briefs, webinars and publications.

CMS Outlines Essential Health Benefits in a Letter to Medicaid Directors
In addition to the essential health benefit proposed rule, the Centers for Medicare & Medicaid Services (CMS) officials sent a guidance letter to Medicaid directors. It offers details about what types of benefits should be provided for low-income adults if states choose to expand their programs. AMCHP also is analyzing the potential impact on MCH populations and will provide further analysis in future materials.

CMS Connect Kids to Coverage
On Nov. 15, CMS announced the kick off of the “Connecting Kids to Coverage” campaign. The goal of the campaign is to raise awareness among eligible families about children’s health coverage under Medicaid and the Children's Health Insurance Program (CHIP), increase enrollment and retention, provide support to local and statewide outreach and education, reenergize and refresh a national campaign that supports and amplifies ongoing outreach efforts. The campaign will focus on the more than four million children who are eligible, but remain uninsured with specific attention on enrolling Native American and African American teenagers.

The campaign will include tailored activities to generate public awareness, campaign toolkits and training/webinars, which will, with organizational and corporate support, emphasizes the importance of partnership and reaching the families where they are. Peaks of campaign activities will focus on flu and cold season, allergy season and back to school time.

Materials are available nationally and are customizable, but the campaign will focus in five key states: California, Texas, Florida, Georgia, Ohio, New York and possibly more. Whether you are in one of the key markets or not, support, guidance and materials are available to anyone requesting it. Support for partners is provided regionally. While not specifically focusing on the opening of the health insurance exchanges in 2014, the campaign will share messages about what should be expected in 2014.

If you have any questions, please contact
Riley Greene at 202-813-4974.

MIECHV Funding Announcement
Both Florida and Wyoming relinquished Maternal, Infant, and Early Childhood Home Visiting (MIECHV) funds and are not participating in the grant program, therefore these funds are open to nonprofit organizations proposing to provide services under the Affordable Care Act (ACA) MIECHV grant program in the states of Florida or Wyoming. For more information on the available funds, please click here.