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 Legislative & Policy Corner

Policy Conference Call: Recording Available
On Jul. 15, AMCHP hosted a member-only conference call to provide an update on emerging policy issues. Topics discussed included the federal budget, sequestration and implementation of the Affordable Care Act. Click here to listen to the recording.

FY 2014 Senate Bill Moves Forward
Last week, the Senate Appropriations committee approved the fiscal year (FY) 2014 Labor, Health and Human Services and Education (LHHS) Appropriation bill. This bill includes $643.8 million in funding for the Title V Maternal and Child Health (MCH) Services Block Grant a $5.2 million increase over President Obama’s FY 2014 budget request. While this legislation is an important indication of the Senate Appropriations Committee funding priorities, it will not move beyond the Senate. The House allocation for the LHHS Appropriation bill is 25 percent below the Senate. It is unclear if the House LHHS bill will see the light of day because in order to achieve this level of cuts, the House would have to propose complete elimination of some agencies or administering sharp across the board cuts crippling the entire U.S. health system.

Oct. 1 marks the beginning of FY 2014 and it appears ever more likely that Congress will have to approve another continuing resolution funding the federal government at the current levels.

Sequestration: The Latest
Experts in Washington, D.C. stated that the hopes for a “grand bargain” to undo sequestration permanently are waning. The current thinking is that members of Congress are looking toward including in the continuing resolution legislative language to postpone sequester for one to three years. The administration is pushing for a three year delay. In order to pay for this delay in sequester, Congress is considering paying for it using a mix of revenue, cuts to entitlement spending and potentially lowering the “caps” or overall amount of funding available for discretionary spending. AMCHP will continue to monitor these developments closely in the upcoming months.  

State by State Chart of FY 2013 VS FY 2012 Released: How do I compare?
AMCHP developed a state by state chart that details the sequestration cuts administered to the Title V MCH Services Block Grant. Due to the data source change input into the formula it appears that some states experienced a slight increase in funding whereas other states experienced deeper cuts. AMCHP will use this chart to illustrate the impact of sequester, however, we need to include stories to add color and life to this data. Please take a moment to fill out our survey so we can capture the impact sequestration has on your state maternal and child health programs and the populations you serve.

Health Reform Implementation

Health Centers Awarded Outreach and Enrollment Funding
On Jul. 10, the U.S. Department of Health and Human Services (HHS) awarded $150 million to 1,159 health centers in the UnitedStates. These funds are meant to enroll uninsured Americans in new health coverage options made available through the Affordable Care Act.

Connecting Kids to Coverage Grants
On Jul. 2, HHS awarded $32 million in grants to support efforts to identify and enroll children eligible for Medicaid and the Children’s’ Health Insurance Program. Forty-one state agencies, community health centers, school-based organizations and non-profit groups in 22 states and two multi-state organizations were awarded grants.

Health Insurance Marketplace Stakeholder Engagement Open Door Forum
The Centers for Medicare & Medicaid Services (CMS) has regular stakeholder engagement on the new Health Insurance Marketplace. The next round of quarterly calls will begin the week of Jul. 29 in each state with a federally facilitated (FFM) or state partnership marketplace (SPM). Individuals and organizations that will interact with and utilize the Marketplace are encouraged to join these calls. CMS will provide an update on the implementation of the Marketplace and listen to feedback as they continue to develop and refine the Marketplace. For more information and to register, please click here.

Nothing Says Summertime Like Regulations
HHS recently released a slew of Affordable Care Act regulations. Here are the ones that are pertinent to MCH populations:

  • On Jul. 12, a final rule was released on standards for Navigators and Non-Navigator Assistance Personnel in state-partnership and federally facilitated exchanges as well as state-based exchanges that are funded through federal Exchange Establishment Grants.
  • On Jul. 5, the final rule on structure and options around Medicaid, Children’s Health Insurance Program (CHIP) and Exchanges. Among many, many issues covered in the rule, are the statutory eligibility provisions, procedural changes to eligibility notices and appeals for Medicaid and CHIP, minimum standard requirements for Alternative Benefit Plans, and updates the Medicaid premium and cost-sharing requirements. The rule also provides guidance to states on CHIP waiting periods, stating that kids cannot wait more than 90 days and encourages states to examine the costs and benefits of waiting periods. The rule also emphasizes that waiting periods are not required. Several groups have had the opportunity to delve into the regulation including Georgetown Center for Children and Families and CMS administrator Marilyn Tavenner.