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 Legislative & Policy Corner

HRSA Allocation Update
The Health Resources and Services Administration (HRSA) released the final allocations for fiscal year 2013 recently. We recognize that various budget tables have circulated in the last couple of weeks with differing numbers. The Title V Maternal and Child Health (MCH) Services Block Grant received the following cuts from its original appropriated fiscal year 2013 amount of $643.9 million.

  • -$32.4 million from sequestration
  • -$4.3 million from the Secretary of Health and Human Services transfer
  • -$2.2 million additional reduction/rescission

The cuts and rescissions bring the final fiscal year 2013 allocation for the Title V MCH Block Grant to $604.9 million, which represents a 5.3 percent reduction below fiscal year 2012 level of $638.6 million. This is the lowest level of Title V Funding since 1991 and represents a $126 million reduction from its highest level in 2003. Please feel free to cite these numbers when referencing cuts to the program. It is our understanding that the Maternal and Child Health Bureau (MCHB) will be communicating additional information to the state MCH programs in the upcoming weeks.

The Budget: What is Next?
Senate Appropriations Chairwoman Barbara Mikulski (D-MD) plans to bring the appropriations bills to the Senate floor at a higher funding level, essentially ignoring sequestration. This means that the Senate and House Labor, Health and Human Services and Education Appropriation bills will vary widely in their allocations and a compromise between the bills seems very unlikely. According to reports by congressional staff, the Senate will consider the Labor, Health and Human Services and Education Appropriation bill this July.

At this juncture, it is very unclear how the federal budgeting process will move forward. According to media reports the House and Senate are on a collision course which will come to a head this October when the debt ceiling needs to be raised, the beginning of the fiscal year and any efforts to undo sequestration will hopefully begin in earnest. It is critical that AMCHP receives stories about what is happening in state maternal and child health programs in light of sequestration and budget uncertainty. If we are unable to tell the story about the impact of these budget cuts, it puts the future of the Title V MCH Block Grant in jeopardy. As a reminder, take a moment to fill out the sequestration survey so AMCHP can capture information about the impact sequestration is having on programs and the populations served by the Title V MCH Block Grant.

In Case You Missed It
On May 30, 2013, AMCHP hosted a webinar The ABCs of ACOs for MCH. Full information, the slides and video are now available on the AMCHP National Center for Health Reform Implementation website.

Medicaid Expansion Report
On Monday, Jun. 3, RAND Corporation released a report with the headline “Expanding Medicaid Is Best Financial Option for States” and that “states that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending, at least in the short term, on the cost of treating uninsured residents, according to a new RAND Corporation study.” The study also found that the cost of uncompensated care in states would be more than the cost of Medicaid expansion. Additionally, the study estimated that by not expanding Medicaid in the 14 states that were studied, that an additional 19,000 deaths could occur annually.

Final Rule Issued on Employee Wellness Programs
The U.S. Departments of Health and Human Services (HHS), Labor and the Treasury issued final rules on employment-based wellness programs. “The final rules support workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health, and limit growth of health care costs, while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status.” Wellness programs include those that reimburse for the cost of membership in a fitness center; that provide a reward to employees for attending health seminars; or for completing a health risk assessment. The final rules will be effective for plan years beginning on or after Jan. 1, 2014.

Final Rule Issued on Exchanges, Qualified Health Plans and Small Business Health Options Program
On Jun. 4, 2013, HHS issued the final rule that “amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.” AMCHP will provide more information on the impact of this and other rules as it is available.