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 Legislative & Policy Corner

Updates on Sequestration, Appropriations, and August Advocacy Opportunities
In case you missed it, please see the Jul. 26 AMCHP Legislative Alert available for updates on these timely issues.

AMCHP Hosts Second Webinar on Supreme Court Decision and the Affordable Care Act
On Jul. 31 at 3 p.m. EDT, AMCHP will be hosting a second webinar on the impact of the Supreme Court decision and the Affordable Care Act as a continuation to the Jul. 2 webinar. This webinar and discussion will delve deeper into the implications of the ruling on Medicaid expansion, as well as current and ongoing opportunities for Title V involvement with ACA implementation. The webinar will cover health insurance exchanges, quality, health benefits, coverage issues, Strong Start and medical homes. The webinar will also highlight various state representatives and who will share the status and efforts of health reform implementation in their states. Preregistration is required for the webinar. Please click here to register.

R40 Maternal and Child Health Research Program
The Maternal and Child Health Bureau (MCHB) announced on Jul. 26, the availability of approximately $2.8 million to support approximately six extramural multiyear research projects. The R40 MCH Research Program supports applied research relating to maternal and child health services, including services for children with special health care needs, that show promise of substantial contribution to advancement of the current knowledge pool, and when used in states and communities should result in health and health services improvements. Findings from the research supported by the MCH Research Program are expected to have potential for application in health care delivery programs for mothers and children. Research proposals should address critical MCH questions such as public health systems and infrastructure, health disparities, quality of care, and promoting the health of MCH populations, which also support the goals of the Health Resources and Services Administration (HRSA). For more information, click here.

Congressional Budget Office Provides Updated Analysis on the ACA after the Supreme Court Ruling
On Jul. 24, the Congressional Budget Office (CBO) provided analysis on the Affordable Care Act (ACA). The report provides estimates on insurance coverage provisions of the ACA in the wake of the Supreme Court ruling. The CBO now estimates that the insurance coverage provisions of the ACA for an 11-year period would have a net reduction of $84 billion. This reduction was mainly due to six million fewer people that will be eligible for Medicaid coverage despite an estimated increase those signing up for federally subsidized insurance exchanges. To read the full report, click here.

Congressional Research Service Provides Repot on Maintenance of Effort
On Jul. 16, the Congressional Research Service provided a memorandum on the effect of the Supreme Court decision on the ACA, specifically on the Medicaid expansion. The memorandum states that states cannot cut their existing Medicaid services and that the Supreme Court ruling has no effect on the “maintenance of effort” provision of the ACA. There was question about this issue due to the Supreme Court ruling stating that states now have the option to adopt the Medicaid expansion rather than possibly losing all Medicaid funds if that state does not participate. While not legally binding, the Congressional Research Service memorandums carry considerable weight. To read the full report, click here.

CMS Administrator Letter to Governors
The Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner sent a letter on Jul. 13, 2012 to the Republican Governors Association in response to an earlier letter. The letter emphasizes the CMS “open door” policy to support states in implementation of health insurance exchanges. The letter also states “the Affordable Care Act gives states significant flexibility in how these Exchanges are set up and run. States can run Exchanges on their own, in collaboration with other states, or in a transitional or permanent partnership with our Department.” The letter also describes the outcome of the Supreme Court ruling on the ACA and implications for Medicaid expansion stating that “A state can receive extra funding for Medicaid IT costs and Exchange implementation costs even if it has not yet decided whether to expand Medicaid eligibility or to run its own Exchange. And, if a state ultimately decides not to do so, it will not have to pay those resources back.” The full letter can be found here.

HHS Regional Implementation Forums
In a letter dated Jul. 10, U.S. Department of Health and Human Services (HHS) Secretary Sebelius addressed governors, emphasizing that “it is time to move forward” with implementation of the Affordable Care Act. The letter also reiterated the flexibility provided to states in the ACA and the commitment the department has to continue to work with governors and their state officials. The letter also announced that HHS will host ACA implementation forums across the country.

The dates and locations are as follows:

  • August 14, 2012: Washington, DC
  • August 15, 2012: Atlanta, GA
  • August 21, 2012: Chicago, IL
  • August 22, 2012: Denver, CO

For more information and to register for the forums, please click here.

Women’s Preventive Health Services Coverage
As part of the ACA, health plans beginning on or after Aug. 1, 2012 will now be required to cover eight preventive services for women without charging a co-payment or a deductable. This requirement for new health plans will contribute significantly to state efforts to improve women’s health overall and efforts to promote preconception and inter-conception care for women of child bearing age. The preventive services included in the law are:

  • Well-woman visits
  • Screening for gestational diabetes
  • Human papillomavirus (HPV) DNA testing for women 30 years and older
  • Sexually-transmitted infection counseling
  • Human immunodeficiency virus (HIV) screening and counseling
  • FDA-approved contraception methods and contraceptive counseling
  • Breastfeeding support, supplies, and counseling
  • Domestic violence screening and counseling

To view the guidelines and for additional information go to: hrsa.gov/womensguidelines/.