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 Legislative & Policy Corner

Final Vote on MCH Program Extensions Set for Week of Apr. 13
On Thursday, Mar. 26, House lawmakers passed a bill in a bipartisan vote of 392-37 to end the "sustainable growth rate" used to calculate doctor's payments for Medicare. This bill also includes a two-year extension of the Children's Health Insurance Program (CHIP); the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program; the Personal Responsibility Education Program (PREP) and Family to Family Health Information Centers (F2Fs), all at current funding levels. Unfortunately, the Senate adjourned for a two-week recess before finalizing the bill. However, Senate Majority Leader Mitch McConnell (R-KY) said the Senate would make the legislation its "first order of business" when they return on Monday, Apr. 13. For additional details and potential advocacy actions see the latest Legislative Alert.
 
Save the Date for May 5 AMCHP National MCH Policy Update Teleconference
Please mark your calendars now for a May 5 teleconference from 2:30-4 p.m. EST. AMCHP will provide an analysis of MCH program reauthorizations; updates and next steps for the budget and appropriations process; and current topics related to the ACA, including the upcoming expected decision in the King v. Burwell case. To register, please click here.

 
Health Reform Implementation

Dear Colleague Letter, WIC Funding
On Mar. 23, more than 100 members of Congress signed a Dear Colleague letter requesting funding for the Supplemental Nutrition Program for Women, Infants, and Children (WIC). The letter was sent to the House Committee on Appropriations. The letter highlights the importance of this program that supports the health and well-being of low-income women and children. The WIC program includes breastfeeding support counselors and breastfeeding support services, and the letter also notes the improvement of breastfeeding rates among women in the program. Breastfeeding continues to be a national priority and is one of the National Performance Measures for Title V programs. AMCHP also has a resource on breastfeeding and the Affordable Care Act, State Opportunities and Strategies for Breastfeeding Promotion through the Affordable Care Act.
 
Well-Woman Visits 
The National Women's Law Center (NWLC) has published resources on making the most of the well-woman visit. Following the passage of the Affordable Care Act (ACA), the well-woman visit was included in Qualifying Health Plans (QHP) as a preventive service women that is not subject to copayment or coinsurance. The NWLC resources include information for consumers, advocates, and provider organizations. More information on preventive services for women can be found here.
 
Community Benefit 
The Hilltop Institute has conducted a survey of community benefit laws at the state level "through the lens of the ACA." The state profiles are organized by the community benefit requirements in the ACA. As state policymakers and community stakeholders assess their state's community benefit landscape in the wake of national health reform, the profiles provide a contextual basis for consideration of these policies against those of other states and federal community benefit benchmarks. The ACA requires nonprofit hospitals to complete a community health needs assessment (CHNA) every three years effective Mar. 23, 2012. AMCHP has developed a fact sheet that outlines the CHNA process and potential opportunities for collaboration with Title V programs. 
 
State Health Insurance Marketplace Plans & Tobacco Cessation 
A new report by the American Lung Association found that the majority of state marketplace plans do not cover the tobacco cessation medications required by federal guidelines. After the passage of the ACA, QHPs sold on the marketplace were required to cover a set of essential health benefits (EHB). One of the EHBs is the inclusion of preventive services that are given an A or B rating by the U.S. Preventive Services Task Force (USPSTF). For tobacco cessation specifically, the USPSTF recommends counseling and all FDA-approved medications. The report found variability in coverage of all approved tobacco cessation medications in both state and federally facilitated marketplaces. This finding has implications in terms of access and cost barriers for adult populations. Access to tobacco cessation is important in the health and well-being of women, children, and families, especially for those women who are planning to or have become pregnant. 

Recently, HHS issued a final rule indicating that they will continue to use a benchmarking process to define and scope out EHBs. The EHB plans will be revisited soon for plan year 2017, and this benchmarking process may provide an opportunity to revisit the tobacco cessation issue. More information can be found here
 
Pregnancy Coverage & Access 
A few weeks ago, several members of Congress wrote a letter to HHS Sec. Burwell, dated Mar. 12, 2015, expressing the need for a special enrollment period for pregnant women. The members of Congress noted that pregnancy should be considered a qualifying life event that triggers special enrollment, similar to the birth or adoption of a child. The letter in its entirety is available here. Access to adequate care during pregnancy can sometimes be difficult to navigate. Some pregnant women face major issues in coverage due to disruption of care or lack of continuity in coverage. This issue can cause delays in important prenatal care and impact the health of mother and child. If your state Title V program is working to address some of the access issues faced by pregnant women, please contact AMCHP policy analyst, Atyya Chaudhry (achaudhry@amchp.org, 202-775-1474) to share some of the particularly innovative work your state is doing. 
 
Special Enrollment Period 
As a reminder, the Centers for Medicare & Medicaid Services (CMS) announced a special enrollment period (SEP) that ends Apr. 30, 2015. This enrollment period is for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes in states that use the federally facilitated marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or did not understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM. More information can be found here
 
Affordable Care Act
The ACA, signed into law on Mar. 23, 2010, is approaching its five-year anniversary. HHS recently announced that approximately 16.4 million people have gained insurance since its passage. This is the largest reduction in the uninsured in nearly four decades, according to Sec. Burwell. The reductions are due in large to several provisions of the ACA, including the expansion of Medicaid, allowing young people to stay on their parents insurance until age 26, and affordable health care options through the Health Insurance Marketplace. Title V has the opportunity to monitor implementation and understand the implications health reform has on MCH populations. Health reform is a constantly changing landscape and to help Title V programs, the Access to Care Core under the National MCH Workforce Development Center, continues to develop resources on this.