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 Legislative & Policy Corner

Budget Deal Signed into Law
On Nov. 2, President Obama signed into law the Bipartisan Budget Act of 2015, which would lift the debt ceiling and raise the budget caps through March 2017. Most notably, this deal would provide equal sequester relief to defense and non-defense discretionary (NDD) spending. This law will increase discretionary spending by $80 billion over two years with offsets coming from a combination of a one-year extension of mandatory spending sequestration, selling oil reserve and airwaves spectrum, and some changes to entitlements to improve program integrity.

While specific programs such as the Title V Maternal & Child Health Services Block Grant are not directly addressed in this bill, we welcome this move to free up additional dollars for non-defense discretionary programs, including public health priorities. The next step will involve Congress reexamining its appropriations bills before current funding expires on Dec. 11. It is unclear how the increased allotment of funds will be distributed through the various appropriations bills, including the Labor, Health and Human Services, and Education bill that houses Title V funding. To that end, we will need to continue to advocate for sustained funding for Title V and reiterate the essential role played by all facets of the Title V MCH Services Block Grant including the state portion as well as funding for Special Projects of Regional and National Significance (SPRANS). As always, AMCHP staff invite you to share stories and examples of Title V successes in your state by contacting Brent Ewig at bewig@amchp.org or Amy Haddad at ahaddad@amchp.org!

Please stay tuned for further information on subsequent appropriations actions.

Neonatal Abstinence Syndrome Bill Passes Senate
On Oct. 23, the Protecting Our Infants Act passed the Senate. This bill would require the Agency for Healthcare Research and Quality (AHRQ) to report on prenatal opioid abuse and neonatal abstinence syndrome (NAS); require the U.S. Department of Health and Human Services (HHS) to review its activities related to prenatal opioid use and NAS and develop a strategy to address gaps in research and programs; and require the Centers for Disease Control and Prevention (CDC) to provide technical assistance to states to improve neonatal abstinence syndrome surveillance and make surveillance data publicly available. A similar bill passed the House earlier this year and now the two bills must be reconciled to make them identical before final passage into law.

Health Reform Implementation

ACA Helps Bring Child Uninsured Rate Down To New Record Low
According to a new analysis of the 2014 American Community Survey data, the rate of uninsured among children has dropped to a historic low of 6 percent following implementation of the Affordable Care Act (ACA) in 2014. The analysis, published by the Georgetown Center for Children and Families, found that this improvement was widespread with 25 states recording statistically significant declines in the number of uninsured children in 2014. Nationally, just under 4.4 million children were uninsured in 2014, and about half of these children live in six states—Texas, California, Florida, Georgia, Arizona and Pennsylvania. The report also found that states that extended Medicaid coverage to more uninsured adults saw nearly double the rate of decline in uninsured children as compared to states that didn't accept the ACA Medicaid option. Read the full report here

Lactation Counseling is a Free Preventative Health Service for Women
There have been many lingering questions about coverage of preventive services under the ACA. Several questions involve coverage of lactation counseling. The health law mandates that all non-grandfathered health plans and insurers provide a list of lactation counseling providers within their network; they must cover out-of-network lactation counseling providers without cost sharing if none are available in network. Plans and insurers cannot limit coverage of lactation counseling to inpatient services, since women generally continue to breastfeed once they leave the hospital following birth. Plans must continue to cover breastfeeding equipment for as long as an enrollee continues to breastfeed. For additional information and clarification regarding the preventive health services benefit, visit healthcare.gov

CMS Releases Marketplace Affordability Snapshot
The next open enrollment period for the Health Insurance Marketplace begins on Nov. 1, 2015 for coverage starting on Jan. 1, 2016. According to a new HHS analysis, roughly eight out of 10 returning consumers will be able to buy a plan with premiums less than $100 dollars a month after tax credits; and about seven out of 10 will have a plan available for less than $75 a month. These predictions were published in the 2016 Marketplace Affordability Snapshot, a report that analyzes enrollment data from the last open enrollment period. Marketplace officials recommend that consumers shop around to find the best plan to suit their needs that falls in their budget before completing the plan selection process during the upcoming enrollment season. Consumers can use this plan finder tool to compare plans available in their area. 

Open Enrollment 2016-How MCH Leaders Can Get to the Table
The Health Insurance Marketplace will begin accepting applications for 2016 coverage on Nov. 1, 2015. This application and plan selection period will remain open until Jan. 31, 2016 (Medicaid and the Children's Health Insurance Program (CHIP) are open for enrollment year-round). MCH professionals are uniquely positioned to share enrollment resources with consumers, including connecting them to navigators and other in-person assisters. These specialists can help people evaluate their health needs, calculate their monthly and annual projected income, and select a plan and a provider that works best for them. Consumer enrollment resources are available from the Kaiser Family Foundation and AMCHP.

Planning Grants for Certified Community Behavioral Health Clinics
Recently, the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Planning and Evaluation (ASPE), awarded $22.9 million to states in efforts to improve behavioral health in their communities by providing community-based mental health and substance use disorder treatment. "The planning grants will help states strengthen payment for behavioral health services for Medicaid and CHIP beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being (HHS 2015)." The criteria for these grants emphasizes high quality, evidence based programs and populations of focus include adults with serious mental illness and children with serious emotional disturbance, among others. Mental and behavioral health is an important issue for MCH populations. Since this funding is focused on the planning phase, it provides a good opportunity for MCH programs to connect with the funding recipients and discuss the needs of MCH populations. The full list of states and more information can be found here.