Legislative & Policy Corner

Save the Date – AMCHP to Convene National All-Member Teleconference on Friday, Feb. 1 at 3 p.m. EST
Please mark your calendar now for an all-member teleconference to be held Friday, Feb. 1 at 3 p.m. EST. The agenda will provide updates on the current fiscal outlook affecting state MCH programs and dialogue about the Jan. 7 Federal Register notice issued by the Maternal and Child Health Bureau (MCHB) announcing the opportunity to comment on a proposed data collection process to analyze Title V programs in the context of the Affordable Care Act. To RSVP for the call, please click here

Budget Update: Fiscal Cliff(s)
During the next two months, Congress will be hard at work making decisions on a host of issues that will have broad implications regarding future funding of the federal government. Specifically, four events are scheduled to occur concurrently:

  • Mid February Raising the debt ceiling: Congress needs to vote on raising the debt ceiling. However, in order to do so, many members of Congress are arguing that raising the limit should result in deeper cuts. As a reminder, two years ago Congress battled over this same issue and that gave birth to the super committee, then the super failure of the super committee to come up with a plan to reduce the deficit, sequestration and the budget control act caps on discretionary spending. AMCHP is deeply concerned that any deal to raise the debt ceiling could result in significant cuts in both entitlements and discretionary spending. According to one analyst, sequestration will seem like a cream puff compared to the potential cuts resulting from the debt ceiling negotiations.
  • March 1 Sequestration: The American Taxpayer Relief Act postponed sequestration until Mar. 1. If sequestration occurs, federal agencies and states should expect across the board cuts in the range of 5-12 percent for all discretionary and nonexempt mandatory programs, including home visiting and Personal Responsibility Education Program (PREP).
  • Mid March President Obama FY 2014 Budget Proposal: The president’s budget may include a proposal to significantly reduce funding in fiscal year 2014 for the Title V MCH Services Block Grant because of the perceived duplication between Block Grant and the Affordable Care Act.
  • Mar. 27 Expiring CR: The federal government is currently operating under a continuing resolution (CR) through Mar. 27, 2013. Congress will either need to approve an appropriations bill or another continuing resolution for the remainder of the fiscal year. Many member of Congress indicated that this may be another way to further reduce federal spending.

At this juncture, AMCHP continues to actively monitor, engage and analyze proposals as they are put forward by Congress and the administration. We will continue to advocate on the behalf of our members and maternal and child health programs by urging for sustained funding of the Block Grant, but now more than ever we will need your help. Please plan on participating in the AMCHP conference hill day, held in conjunction with our annual conference. Click here to learn more or contact Carolyn Mullen cmullen@amchp.org for additional information.

Sequestration Update
According to current law, sequestration is scheduled to occur on Mar. 1. The administration and Congress have yet to engage in discussions on how to avert sequester. Last week, the Office of Management and Budget (OMB) issued a memo to federal agencies entitled, “Planning for Uncertainty with Respect to Fiscal Year 2012 Budgetary Resources.” It is important to note that OMB is urging agencies to step up their planning for the potential cuts; however, at this time they should not make any reductions specifically in response to sequester. The memo provides the following guiding principles that federal agencies should use in preparing plans to operate with reduced budgetary resources in the event that sequestration occurs:

  • Use any available flexibility to reduce operational risks and minimize impacts on the agency core mission 
  • Identify and address operational challenges that could potentially have a significant deleterious effect on the agency mission
  • Identify the most appropriate means to reduce civilian workforce costs where necessary this may include imposing hiring freezes, releasing temporary employees or not renewing term or contract hires, authorizing voluntary separation incentives and voluntary early retirements or implementing administrative furloughs
  • Review grants and contracts to determine where cost savings may be achieved in a manner that is consistent with the applicable terms and conditions
  • Take into account funding flexibilities including the availability of reprogramming and transfer authority
  • Be cognizant of the requirements of the Worker Adjustment and Retraining Notification

AMCHP continues to work with broad coalitions urging Congress to address the deficit through a balanced approach that does not further reduce discretionary spending.

CMS Issues a Mega-Rule
On Jan. 14, the Centers for Medicare & Medicaid Services (CMS) issued a rule on all things Medicaid, Children's Health Insurance Program, exchanges, alternative benefits plans, appeals processes in a more than 400 page document. AMCHP, in collaboration with other Washington, DC children’s organizations will analyze the rule. Stay tuned for more information. CMS also provided a fact sheet, which is much shorter.

CMS Issues Letters to State Medicaid and Health Officers on Health Homes
On Jan. 15, CMS issued a letter in regards to Health Home Quality Core Measures. “While CMS is not requiring states to use these measures until the regulations are promulgated, states requested that we share these measures in advance of rulemaking. In keeping with the collaborative process on the health home provision, CMS is sharing the core set to help states as they consider the design and implementation of their health home programs. This advance notice will also give states time to share information with their health care providers, which is important, since health home providers will be required to report health care quality measures in order to receive payment.” The recommended health home core measures are: 1) adult body mass index (BMI) assessment; 2) ambulatory care – sensitive condition admission; 3) care transition – transition record transmitted to health care professional; 4) follow-up after hospitalization for mental illness; 5) plan – all cause readmission; 6) screening for clinical depression and follow-up plan; 7) initiation and engagement of alcohol and other drug dependence treatment; and 8) controlling high blood pressure.

In Connection with the President’s Announcement in Response to the Sandy Hook Tragedy
On Jan. 16, CMS released a state health official letter on the application of the Mental Health Parity and Addiction Equity Act to Medicaid managed care organizations, the Children’s Health Insurance Program (CHIP), and alternative benefit (benchmark) plans. 

HHS Relaunches HealthCare.gov Website and Social Media Tools
The U.S. Department of Health and Human Services (HHS) recently updated HealthCare.gov in anticipation to many of the pieces of the Affordable Care Act that will come into place in 2013 and beyond, notably, the health insurance exchanges. New features, such as e-mail and text message updates for consumers have been added. Consumers can find resources in many places including HealthCare.gov, The Secretary’s Blog, Twitter and Facebook. Please direct any questions about these tools to HHSIEA@hhs.gov.