February 08, 2013

February 8 Washington Update

Greetings from Washington.  Good news - Representative Frank Pallone (D-NJ) has introduced a bill to extend funding for Family-to-Family Health Information Centers (F2Fs) through FY 2016!  Details on this and more are below.

Note:  If you are coming to DC for the AMCHP conference, have time to make congressional visits, and have not already told us about your plans, please contact Brooke or me, and/or stop at the Family Voices table to get materials to take to Capitol Hill.  Brooke or I will be at the table during the Monday afternoon and Tuesday morning breaks.

F2F funding bill introduced.  On February 6, Representative Frank Pallone (D-NJ) introduced a bill (H.R. 564) to extend funding for Family-to-Family Health Information Centers through FY 2016 at the current funding level of $5 million per year.  (The legislation does not propose to increase funding for the program given the realities of this budget-cutting political environment.)  Now it is up to family leaders around the country to get their Representatives to cosponsor the legislation.  It would be especially helpful if we could get some Republican cosponsors so the bill will be bipartisan.  To find your Representative and his/her contact information, see www.house.gov.   

CMS seeking comments on a draft application to be used for private insurance, Medicaid, CHIP and premium tax credits  (NEW INFO. ADDED)

As noted last week, comments are being sought on the online and paper applications that people and small businesses will use to apply for Medicaid, CHIP, private insurance offered by health insurance Exchanges/Marketplaces, and premium tax credits.  (See description and links to documents and video, below.)

* NEW:  CMS is hosting a webinar to discuss the proposed application on Monday:

Date: Monday, February 11, 2013
Time: 1:00pm - 2:30pm (EST)
Call-In Number: 877-267-1577
Passcode: 5620

To log in, go to: https://webinar.cms.hhs.gov/learnmoressapp2/

Given your experience in helping people with the application process, you probably have some very valuable insights about how these proposed applications will work for consumers, so please consider commenting and/or sending your thoughts to me so that we can pass them along to HHS.  The comment period closes on February 28. 

As explained by the Centers for Medicare and Medicaid Services (CMS):

CMS is seeking public comment on the new single, streamlined application for health insurance and the SHOP [small business] applications in preparation for the launch of a new Health Insurance Marketplace next fall. 

The individual application is a single point of entry to purchase private insurance on the Marketplace and assess eligibility for assistance including, Medicaid, CHIP, and the Advanced Payment of Tax Credits.  People are asked to review the paper and online applications.  To demonstrate how users may interact dynamically with the online application, CMS has posted two videos of the application being completed.  One follows a family of three and the other an individual.  The video demonstrations are available at http://www.youtube.com/user/CMSHHSgov

Note:  the links below will take you to CMS website pages from which you can download a zip file.  In the zip file will be the draft application and explanatory documents for commenters.

Individual Application (CMS-10440) http://cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10440.html

SHOP [small business] Employee Application (CMS-10438) http://cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10438.html

SHOP [small business] Employer Application (CMS-10439) http://cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10439.html

Comments should be submitted to:  

OMB, Office of Information and Regulatory Affairs
Attention: CMS Desk OfficerFax Number: (202) 395-6974
E-mail: OIRA_submission@omb.eop.gov

Patient Navigators, Assisters, and Certified Application Counselors.  F2Fs should be exploring ways that they can continue to serve as health system navigators, with additional funding, by serving as one of the types of consumer-assistance entities created to implement the ACA.  See the Community Catalyst blog this week about these entities.  This week's blog of the Georgetown Center for Children and Families discusses problems with state implementation of the ACA's navigator provision. See also this recent Washington Post article about navigators.

Other ACA-related news and information

Basic Health Program delayed.  The administration announced this week that it would delay implementation of the "Basic Health Program," an optional coverage program allowing states to use federal tax subsidy dollars to offer subsidized coverage for some individuals with incomes between 139-200% of the federal poverty level in order to reduce the cost of health insurance coverage for these low-income consumers.  See Kaiser Health News article at http://capsules.kaiserhealthnews.org/index.php/2013/02/hhs-delays-basic-health-plan-option-until-2015/.

On February 6, CMS posted a set of frequently asked questions discussing the Basic Health Program, and other ACA-related issues. These and other helpful FAQs can be found here.

Projected reduction in employer-sponsored insurance coverage.  The Congressional Budget Office (CBO) issued new budget projections this week, which included a prediction that the number of people to be covered by employer-sponsored insurance will decrease as a result of recent changes in tax law in combination with the ACA.  See CBO summary with link to the report at http://cbo.gov/publication/43907, and Washington Post article at http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/05/three-ways-cbo-expects-health-spending-to-change/.   

Premium increases for people in individual market.  The Kaiser Family Foundation issued a brief estimating that average, unsubsidized premiums for nongroup coverage will be somewhat higher under reform than they are today because benefits will be more generous.  The brief also notes that, while patient cost sharing will still be quite high, everyone's out-of-pocket costs will be capped.  An article about the brief can be found at http://capsules.kaiserhealthnews.org/index.php/2013/02/study-premium-increases-to-be-offset-by-subsidies-better-coverage/.

WORTH REPEATING: SAMHSA announces grants for Statewide Family Networks and Statewide Consumer Networks

From the SAMHSA press release at http://www.samhsa.gov/newsroom/advisories/1301175742.aspx:  The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for Statewide Family Network to create state capacity and infrastructure that will enable families to act as catalysts for mental health and other system change by developing community-based, family-driven and youth-guided systems of care for children and adolescents with serious mental health needs.  These grants will provide information, referrals, and support to families who have a child with a serious mental health need and create a mechanism for families to participate in state and local mental health services planning and policy development.  Domestic public and private nonprofit entities that meet the criteria for consumer-controlled organizations are eligible to apply. Applications are due on March 7, 2013. 

From the SAMHSA press release at http://www.samhsa.gov/newsroom/advisories/1301175800.aspx:  The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for Statewide Consumer Network grants to enhance statewide consumer-run organizations to promote service system capacity and infrastructure development that is recovery-focused and resiliency-oriented.  For the purposes of this funding opportunity, this program seeks to promote activities related to wellness, integrated care, health care reform, and a trauma-informed approach.   Domestic public and private nonprofit entities that meet the criteria for consumer-controlled organizations are eligible.  Applications are due on March 8, 2013.


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

Best, Janis & Brooke

Janis Guerney, Esq.

Brooke Lehmann, MSW, Esq.