May 11 Washington Update
Greetings from Washington. This week, another Senator has joined as a cosponsor of the F2F funding bill, HHS released proposed regulations on Medicaid payments for primary care services, and the House passed a bill that would jeopardize Medicaid and CHIP eligibility for children. This update also provides information about two interesting webinars next week.
F2F funding bills (S. 2123 and H.R. 4083)
Since last week, another Senator has joined as a cosponsor to the Menendez bill - Senator Amy Klobuchar (D-MN). It is not a coincidence that this addition - along with last week's addition of Rep. André Carson (D-IN) to the House bill - followed visits to the Hill by F2F grantees to educate Members of Congress about the program. The current tally is 10 House cosponsors, in addition to sponsor Representative Pallone (D-NJ), and seven Senate cosponsors, in addition to Senator Menendez (D-NJ). It's great to see this progress, but we still need to show bipartisan support among many more Members of Congress if we hope to get the F2Fs re-funded.
So, if your Members of Congress have not yet cosponsored the legislation, please contact them to ask that they do so. See the guidance at the end of this update or click here now to send a pre-drafted letter to your Representative. Also, please forward this information to your family, friends, and health care providers, and ask them to contact their Members of Congress as well.
And, if you haven't done so already, please thank your Senator(s) and Representative who have cosponsored the legislation. You can find their contact information by clicking on their names on the list of cosponsors at the end of this update.
Medicaid reimbursement to physicians. The Administration issued a proposed regulation this week to implement a provision of the Affordable Care Act (ACA) that mandates improved Medicaid payment rates for primary care services for FYs 2013 and 2014. Under section 1202 of the ACA, states must provide at least the Medicare payment rate for these services. Medicare payment rates are generally significantly higher than current Medicaid rates. Significantly, the proposed rule will allow subspecialists in the field of pediatrics, general internal medicine and family medicine to receive these reimbursement rates if they are providing certain primary care services. Thus, when a child with special health care needs is receiving primary care services from a pediatric cardiologist, for example, that physician is entitled to the Medicare payment rate. Hopefully, this policy will improve access for Medicaid patients and make it easier to receive primary care services from subspecialists.
As mentioned above, this provision is only effective for two years. No doubt, doctors will be lobbying for an extension of the payment law after that. For more information, see http://healthaffairs.org/blog/2012/05/10/implementing-health-reform-increasing-medicaid-payments-for-primary-care-physicians/ or the HHS press release at http://www.hhs.gov/news/press/2012pres/05/20120509b.html. The proposed rule itself can be found at http://www.ofr.gov/OFRUpload/OFRData/2012-11421_PI.pdf.
House Republican budget bill. On Thursday, the House passed a bill to provide alternative budget cuts to replace the automatic cuts in government spending ("sequester") that is scheduled to take effect next year. This bill would make serious cuts in Medicaid and other safety net programs, including SNAP (Food Stamps), and the ACA's prevention and public health fund. It would eliminate the ACA "maintenance-of-effort" (MOE) provision that requires states to maintain their Medicaid and CHIP eligibility rules and enrollment and renewal procedures until 2019 for children. The House bill would also eliminate the federal incentive payments that reward states for enrolling more Medicaid-eligible children into coverage.
A Kaiser Family Foundation fact sheet (2 pp.) on the MOE requirement, and the impact of its repeal, can be found at http://www.kff.org/medicaid/upload/8204-02.pdf. A fact sheet on the Medicaid provisions prepared by the Georgetown Center for Children and Families can be found at http://ccf.georgetown.edu/index/cms-filesystem-action?file=ccf%20publications/federal%20medicaid%20policy/energy-and-commerce-factsheet.pdf.
The bill incorporated the recommendations of several House committees. According to the New York Times (http://www.nytimes.com/2012/05/11/us/house-approves-310-billion-in-cuts.html?_r=1&emc=tnt&tntemail0=y),
"...the committees cut food stamps, children's health insurance and Medicaid, eliminated the Social Services Block Grant to state and local governments (which pay for Meals on Wheels, child abuse prevention and other programs) and eliminated a new fund intended to help the government liquidate failed financial giants.
"Of the savings, $23.5 billion came from Medicaid and children's health care; $4.2 billion from hospitals that serve the poor and uninsured; and $33.7 billion from supplemental nutrition assistance. In all, about a quarter of the cuts would come directly from programs that benefit the poor.
"The nonpartisan Congressional Budget Office estimated that more than 20 million children would face reduced food and nutrition support, almost 300,000 would be knocked off the federal school lunch program and at least 300,000 would lose access to the State Children's Health Insurance Program."
Fortunately, it is safe to say that the House bill will not be able to pass the Senate. Nevertheless, the bill portends some of the proposals that might be put forward in the post-election lame-duck session of Congress, when it is expected that there will be serious consideration of legislation to replace the sequester with other funding cuts and/or revenue increases in order to avoid deep cuts in defense spending.
Monday, May 14 webinar on the future of CHIP and children's coverage. On Monday, May 14, from 2:00 - 3:00 pm (EDT), The National Academy for State Health Policy will be holding the first of a two-part webinar series on children's coverage and health reform. You can register for the webinar at http://nashp.org/nashp-webinars. For more information, contact Hannah Richardson at firstname.lastname@example.org.
Wednesday, May 16 Catalyst Center webinar on the "Medicaid/CHIP 101" tutorial. The Catalyst Center is hosting a 5-part (free) webinar series to provide an overview of its newly released Medicaid/CHIP 101 Tutorial, Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children's Health Insurance Program (CHIP).
The second session of the series will be held on Wednesday, May 16, from 1-2:00 ET, and is titled "Understanding the Basics: Medicaid & CHIP Programs and Building Partnerships with Stakeholders." You can get more information and register at http://hdwg.org/catalyst/medicaid-tutorial-webinar. If you have questions about the webinar series please contact Meg Comeau.
As always, please feel free to contact us with any questions.
NOTE: Past issues of the Washington update can be found on the Family Voices home page by scrolling down in the "News Feed" section.
Cosponsors of House F2F funding bill, H.R. 4083, sponsored by Rep. Frank Pallone (D-NJ):
Rep Langevin, James R. [RI-2] - 2/17/2012
Rep Norton, Eleanor Holmes [DC] - 2/17/2012
Rep Pingree, Chellie [ME-1] - 2/17/2012
Rep Cicilline, David N. [RI-1] - 2/17/2012
Rep Michaud, Michael H. [ME-2] - 2/17/2012
Rep Engel, Eliot L. [NY-17] - 2/17/2012
Rep Green, Gene [TX-29] - 3/5/2012
Rep Rangel, Charles B. [NY-15] - 3/8/2012
Rep Roybal-Allard, Lucille [CA-34] - 3/20/2012
Rep Carson, Andre [IN-7] - 4/26/2012
Cosponsors of Senate F2F funding bill, S. 2123, sponsored by Senator Robert Menendez:
Sen Bingaman, Jeff [NM] - 2/17/2012
Sen Conrad, Kent [ND] - 2/17/2012
Sen Snowe, Olympia J. [ME] - 2/17/2012
Sen Whitehouse, Sheldon [RI] - 2/17/2012
Sen Lautenberg, Frank R. [NJ] - 2/17/2012
Sen Kerry, John F. [MA] - 3/13/2012
Sen Klobuchar, Amy [MN] - 5/8/2012
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 home phone number and email address.
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.