March 16, 2012

March 16 Washington Update


There are several things to report this week, particularly related to regulations implementing the Affordable Care Act (ACA).  But first, an update on the F2F funding legislation.

F2F funding bills

We are still working to secure more cosponsors for the Senate and House bills (S. 2123 and H.R. 4083) -- sponsored by Senator Robert Menendez (D-NJ) and Representative Frank Pallone (D-NJ), respectively -- to extend the current level of funding ($5 million) for F2Fs through Federal FY 2015. 

We have gained three new cosponsors since the bill was introduced:  Senator John Kerry (D-MA), and Representatives Charles Rangel (D-NY) and Gene Green (D-TX).  If you represented by any of these Members, please consider contacting their offices to thank them.  You can call them through the Capitol switchboard at 202-224-3121, or use their web forms, found through www.senate.gov or www.house.gov.

Those of you coming to DC for the F2F conference in April:  Please try to make appointments with your Members of Congress to discuss F2F funding.  Instructions about how to do so are attached.  Also, please plan to participate in a conference call on Tuesday, April 10, at 3:00 ET to discuss the funding history and status of the F2F program so you are well-prepared to field questions from legislative staff.

Everyone:  Please contact your Members of Congress by phone or email to urge them to cosponsor the Menendez-Pallone legislation.  See guidance at the end of this update or click here now to send a pre-drafted letter to your Representative.

Regulations to implement the ACA  

The Department of Health and Human Services (HHS) has been very active recently in issuing various proposed and final rules to implement the ACA. 

Regulation on Exchanges.  Earlier this week the department released a 644-page final rule (with some interim final components) to govern the operation of state Exchanges through which uninsured individuals can purchase health insurance.  The final rule includes some improvements over the proposed rule, including a requirement that state Exchange governing boards (if the Exchange is an independent state agency or a non-profit) must include at least one consumer representative.  Nonetheless, advocates will have to be vigilant about the operation of Exchanges in their states.  This rule did not include details about federally run Exchanges in states that decline to establish their own Exchanges.  A short explanation and discussion of this rule can be found on the blog of the Georgetown Center for Children and Families at http://theccfblog.org/2012/03/final-exchange-rules-part-1.html.   A more thorough summary can be found at http://www.healthcare.gov/news/factsheets/2011/07/exchanges07112011a.html.  

Regulation on Medicaid and CHIP eligibility. Today the department released a final rule on Medicaid and CHIP eligibility.  Although it includes some improvements, it also provides states with more flexibility about the eligibility determination process than did the proposed rule.  The proposed rule would have required the state Exchanges to determine eligibility for federal premium subsidies or Medicaid. But the final rule allows states the option of having Exchanges make only an initial determination of eligibility for Medicaid while allowing state Medicaid agencies to make the final decision.

To decrease documentation burdens, the final rule will require Exchanges and state Medicaid agencies to use state and federal databases, such as those kept by the Internal Revenue Service and Social Security, to help verify applicants' income levels and other information needed to establish eligibility.  The final rule also included new consumer protections that were not included in the proposed rule.

A fact sheet on the final eligibility rule can be found at http://www.medicaid.gov/AffordableCareAct/Provisions/Downloads/MedicaidCHIP-Eligibility-Final-Rule-Fact-Sheet-Final-3-16-12.pdf

Tuesday conference call on regulations. This coming Tuesday, March 20, at 1:00 ET, the Georgetown Center on Children and Families will be conducting a conference call for state advocates to review and answer questions about these regulations.  CMS officials will be participating.  The call-in number is (866) 206-7202.

Webinar on Supreme Court case on ACA (see attachment)

On March 26 through 28, the Supreme Court will be hearing oral arguments on the case brought by 26 states to challenge the constitutionality of the ACA.  This coming Wednesday, March 21, 8:00-9:00 PM, American Academy of Pediatrics will be hosting a free webinar about the case.  The keynote speaker will be Jane Perkins, the Legal Director for the National Health Law Program, who will provide a detailed overview of each of the issues before the Supreme Court, and outline how the Court's decision will impact the future of the law and the children and families affected by it.

Space is limited, so it is recommended that you register by Monday, March 19.  To register, go to https://www3.gotomeeting.com/register/351277174.  If you have a specific question about what the Supreme Court's oral arguments could mean for children, you can e-mail it to the AAP Department of Federal Affairs at kids1st@aap.org by 12:00 pm ET on March 20, 2012.

ACA Anniversary/"MyCare" stories

The White House and advocacy groups are preparing for the second anniversary of the ACA's enactment (March 23), with various events occurring every day next week.  Today, HHS Secretary Kathleen Sebelius unveiled "MyCare," a collection of online personal video and blog stories of Americans helped by the Affordable Care Act.  A promotional video can be found at http://www.youtube.com/watch?v=TW6SJrX1ROw, and additional information is at http://www.healthcare.gov/mycare.  Individuals can share their own stories by using the Twitter hashtag #MyCare or visiting facebook.com/HealthCareGov

Families can also share their stories - about the ACA, F2F assistance, Medicaid, or other issues - through the Family Voices website at http://www.familyvoices.org/action/share

Medicaid proposals in Congress

Although they are not an immediate threat, some disturbing proposals to restructure the Medicaid program have been floated this week.  One, developed by the House Republican Study Committee, would block grant Medicaid and CHIP at the current spending level for the next ten years.  (See http://rsc.jordan.house.gov/Solutions/statehealth.htm .) The other, under development by Representative Bill Cassidy (R-LA), would place a per capita limit on Medicaid spending.  For an article about these proposals, see http://thehill.com/blogs/healthwatch/medicaid/214701-republicans-float-dueling-medicaid-reform-bills

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As always, please feel free to contact us with any questions. 

Happy Friday!

Brooke Lehmann, MSW, Esq.
202-333-2770
blehmann@familyvoices.org

Janis Guerney, Esq.
202-546-0558
jguerney@familyvoices.org

NOTE:  Past issues of the Washington update can be found on the Family Voices home page by scrolling down in the "News Feed" section.

Contacting your Members of Congress about F2F funding bills

All of you who are concerned about the future of F2Fs should contact your Members of Congress to urge that they cosponsor the Menendez or Pallone bill. You can call them through the Capitol switchboard at 202-224-3121.  (To find the names of your Members of Congress, go to http://www.congressmerge.com/onlinedb/index.htm.)  When you speak to the receptionist, state that you are a constituent and ask to speak to the staff person who handles health issues.  If that person is not available to talk, you can leave a BRIEF message identifying yourself as a constituent who has a child with special health care needs (if applicable) and asking that the Representative/Senator cosponsor a bill that would extend funding for Family-to-Family Health Information Centers.  Refer to the appropriate bill number and sponsor - in the Senate, S. 2123, sponsored by Senator Menendez; in the House, H.R. 4083, sponsored by Rep. Pallone.  Leave your phone number and email address. (Remember to use your personal contact information, not that of your F2F.)

You can also write to your Representative (even if you call) via the "Advocacy" section of the Family Voices website, where you will find a pre-written letter that you fill in with your personal information.  (You do not need to know the name of your Representative.)  Please ask families you have worked with, friends, and relatives to write their Representatives through the Family Voices website also.  The URL is http://www.familyvoices.org/action/advocate.   At this time, the website is not configured to automatically send the letter to Senators, but simple instructions about how to contact your Senators, and text to copy and paste, can also be found on that page.  (You do not need to know the names of your Senators.)

Remember:  Federal resources may not be used for lobbying activities.

Please feel free to call Brooke or Janis (contact information above) if you have any questions.