July 13, 2012

July 13 Washington Update

Greetings from Washington.  This update will focus on the legislation to extend federal funding for F2Fs, a new Family Voices effort to help F2Fs use social media (which will help to support the legislation), and implementation of health care reform after the Supreme Court decision.

F2F funding bills (S. 2123 and H.R. 4083).  We have one new cosponsor of the House bill this week - Representative Henry Waxman (D-CA), Ranking Minority Member of the Committee on Energy and Commerce.  His support is significant, since that committee has jurisdiction over the Pallone legislation.  This brings us up to a total of 11 House cosponsors, in addition to Representative Pallone (D-NJ).

There are no new cosponsors of the Menendez bill this week, so the tally stands at nine Senate cosponsors, in addition to Senator Menendez.  Cosponsors of both bills are listed at the end of this update.

The policy team continues efforts to garner congressional support for the legislation by meeting with Hill staffers, particularly those of Senate Finance Committee members.  As some of you know, we are copying the F2Fs from the applicable states on email correspondence with the staffers, and letting them know that they can get more information from you about the F2F in your state. 

If we hope to get the F2Fs re-funded, Members of Congress will need to hear from F2Fs about how effectively they are spending their federal grant funds, and from families about how important F2F services have been in their lives.

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.  Please forward this information to your family, friends, health care providers, and other families of CYSHCN 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.

New assistance in using social media to promote F2Fs.  Lawmakers and their staff members are only human, and it helps them understand the importance of F2Fs if they hear a story about how an F2F has helped a particular family.  Family Voices' Director of Communications & Strategic Initiatives, Melanie Rubin, is working hard to make sure that the successes of F2Fs are well-known.  One of the ways to spread the word is through "social media" like Facebook and Twitter. 


On Thursday (7/12) you should have received an announcement from Melanie about the FV social media campaign.  Her message provides information about upcoming webinars on using social media, which will take place on July 30 and August 21.  It also includes instructions for maximizing your Facebook and Twitter impact if you are already using those tools.  As Melanie said, "Creating a strong, interconnected, social media network that can quickly share information about the work and of FV SAOs and F2Fs is probably the most effective, low-cost, time-efficient way to lay the groundwork that will help [F2Fs to] stay funded."

ACA implementation after the Supreme Court decision 

Exchanges.  Many state leaders had been waiting to see if the Affordable Care Act (ACA) was declared constitutional by the Supreme Court before starting to develop state insurance "Exchanges" through which to sell insurance to individuals and small businesses.  Governors of several states -- LA, SC, TX, FL, ME, and NH -- have indicated that their states will not establish Exchanges, meaning that the federal government will run them.  During the past week, other governors have indicated that Exchanges will be developed in their states (CA, CO, CT, HI, MD, MA, MN, NY, OR, RI, VT, WA, KY).  Some other states have already begun the process of establishing their Exchanges.   See http://www.californiahealthline.org/articles/2012/7/13/12-governors-affirm-commitment-to-health-insurance-exchanges.aspx.  States are supposed to let HHS know whether they will run their own Exchanges by November of this year.

Medicaid expansion.  The Supreme Court's decision essentially made optional the ACA's Medicaid expansion, which was intended to cover all individuals under age 65 with incomes below 133% of the Federal Poverty Level (FPL).  (This population consists mainly of low-income, childless adults, but may include some people with disabilities who do not get Medicaid on some other basis, such as those who can work but have jobs that do not offer insurance coverage.)

Since the Court's decision, governors have had many questions for the Department of Health and Human Services (HHS) regarding the Medicaid expansion.  In a letter to HHS Secretary Kathleen Sebelius, the National Governors Association asked, among other questions, the most prominent one that has arisen:  "Will states that expand Medicaid coverage up to a level below 133 percent of the federal poverty limit (FPL), for example up to 100 percent FPL, still receive the enhanced federal medical assistance percentage (FMAP) available for "newly covered" populations?"

States have a financial incentive not to cover individuals with incomes between 100 and 133 percent of the FPL because those people are eligible for premium subsidies - paid for entirely by the federal government -- to purchase insurance in the Exchanges.  Since the ACA did not provide for premium subsidies to those with incomes below 100 percent of the FPL, however, states will be more inclined to make them eligible for Medicaid, especially since the cost during the first three years is covered entirely by the federal government.  In addition, it is expected that public hospitals and other providers who care for the uninsured will pressure policymakers to expand Medicaid eligibility.  A USA Today survey  found that more than half of the Governors are undecided about whether to adopt the Medicaid expansion. 

Secretary Sebelius responded to the NGA letter, indicating that the administration wants to work with the states, and afford them flexibility in implementing the ACA. 

The Republican Governors Association also had a number of questions for the administration, about both Exchanges and Medicaid, which they posed in a July 10 letter to President Obama.  On July 13th, the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), Marilynn Tavenner, responded to that letter with more substantive information than the Secretary's letter included.   Tavenner's letter told the states that there is no deadline by which they must decide if they will adopt the Medicaid expansion.  She also informed them that "a state can receive extra funding for Medicaid IT costs and Exchange implementation costs even if it has not yet decided whether to expand Medicaid eligibility or to run its own exchange,"  and the state would not have to return that money if it ultimately decided not to establish its own Exchange or expand its Medicaid program. 

Regional forums on ACA implementation.  In her letter to the governors, the Secretary announced four regional forums at which state officials and others could pose questions and provide comments about ACA implementation. The forums are scheduled for July 31 in Washington, DC; Aug. 2 in Chicago; Aug. 10 in Denver; and Aug. 15 in Atlanta. To register for a forum, go to https://www.quickbase.com/db/bg92mriu2.

Webinars on the ACA.  The HHS Center for Faith-Based and Neighborhood Partnerships is hosting a series of interactive webinars on the ACA, in English and Spanish.  To RSVP, or for more information, go to http://www.hhs.gov/partnerships/resources/aca_101-invite.html.

National Webinars

July 19, 12:30 pm ET - The Health Care Law 101 (in English)

July 24, 2:00 pm ET - The Health Care Law 101 (in Spanish)

Regional Webinars

July 17, 10:30 am CT - Region 7 (Iowa, Kansas, Missouri, Nebraska)

 August 8, 11:00 am ET- Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)



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

Brooke Lehmann, MSW, Esq.

Janis Guerney, Esq.

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 Carson, Andre [IN-7] - 4/26/2012
Rep Cicilline, David N. [RI-1] - 2/17/2012
Rep Engel, Eliot L. [NY-17] - 2/17/2012
Rep Green, Gene [TX-29] - 3/5/2012
Rep Langevin, James R. [RI-2] - 2/17/2012
Rep Michaud, Michael H. [ME-2] - 2/17/2012
Rep Norton, Eleanor Holmes [DC] - 2/17/2012
Rep Pingree, Chellie [ME-1] - 2/17/2012
Rep Rangel, Charles B. [NY-15] - 3/8/2012
Rep Roybal-Allard, Lucille [CA-34] - 3/20/2012
Rep Waxman, Henry A. [CA-30] - 7/9/2012

Cosponsors of Senate F2F funding bill, S. 2123, sponsored by Senator Robert Menendez:

Sen Akaka, Daniel K. [HI] - 6/4/2012
Sen Bingaman, Jeff [NM] - 2/17/2012
Sen Conrad, Kent [ND] - 2/17/2012
Sen Franken, Al [MN] - 6/5/2012
Sen Kerry, John F. [MA] - 3/13/2012
Sen Klobuchar, Amy [MN] - 5/8/2012
Sen Lautenberg, Frank R. [NJ] - 2/17/2012
Sen Snowe, Olympia J. [ME] - 2/17/2012
Sen Whitehouse, Sheldon [RI] - 2/17/2012

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.