June 01, 2013

May 31 Washington Update

Greetings from Washington, DC!  Congress has been on recess this week, and the flow of regulations has slowed a bit, but this update includes information on some interesting webinars coming up and the launch of an unusual website through which the public can communicate with key tax policymakers in Congress.


Premium Tax Credits.  The Center for Budget and Policy Priorities (CBPP) will be holding a webinar on Wednesday, June 5, at 1 pm Eastern time (10am Pacific) about premium tax credits under the Affordable Care Act (ACA).   They held the same webinar last week (sorry -- I didn't know about it) so if you participated in that one, no need to repeat unless you want to.  You can register here.

The webinar should be very useful for those trying to get up to speed on one of the more complicated aspects of ACA implementation - premium tax credits.  It will go beyond the basics of who will qualify for premium tax credits to examine some of the major technical issues involved in how the credits work, including how they are calculated, the impact of mid-year changes in a person's income or household size, and how the reconciliation between the premium tax credit amount a person received and the amount for which he or she was eligible will be handled. 

CBPP FAQs on the premium tax credits and other cost-sharing assistance can be found here.  For questions, please contact Jesse Cross-Call at cross-call@cbpp.org.

Health Insurance for (Immigrant) Children and Youth with Special Health Care Needs. Thursday, June 6, 11:00 AM - 12:00 PM EDT.  This webinar, hosted by the National Center for Ease of Use of Community-based Services, will provide information about eligibility for public and private health insurance for CYSHCN from immigrant families and explore the provisions of the Affordable Care Act aimed at removing barriers to care.  Register here.

Health Insurance Marketplaces (Exchanges).  CMS has announced series of training webinars about Exchanges to be held in June and July.  There will be two levels, basic and advanced.  Space is limited, but the webinars are offered on multiple dates.  The schedule and registration links are at the end of this update.


Website on Tax Reform.  In a somewhat unusual (and bipartisan) move, the chairmen of the House and Senate tax-writing committees - Rep. Dave Camp (R-MI), of the House Ways and Means Committee, and Sen. Max Baucus (D-MT) of the Senate Finance Committee - have launched a website, www.taxreform.gov, through which they are soliciting public ideas on tax reform.  You can also follow "Max & Dave" on Twitter, @simplertaxes.

The Arc points out that plans being developed to overhaul the tax system will determine how much funding is available in coming years for the various tax-funded programs of importance to people with disabilities and special health care needs - both social insurance and entitlement programs (e.g., Social Security Disability Insurance, Medicaid and SSI) and discretionary programs (e.g., housing, education, employment, transportation), and suggests comments that can be submitted to these tax policy leaders. 

F2F funding legislation.  Since Congress has been in recess this week, there are no new cosponsors of the F2F funding bills.  If you would like to urge your Representative and/or Senators to cosponsor these bills, you can find their contact information at http://www.congressmerge.com/onlinedb/index.htm


The President's Committee for People with Intellectual Disabilities (PCPID) within Administration on Intellectual and Developmental Disabilities (AIDD) recently released Managed Long-Term Services and Supports: 2012 Report to the President, which provides recommendations regarding Managed Long-Term Services and Supports (MLTSS) for individuals with intellectual and developmental disabilities.  It also includes background information on MLTSS to assist the intellectual and developmental disability community with understanding the changes occurring and ways to influence outcomes.  Summary / Full Version of the PCPID report.

Small Business Health Options Program.  On May 31, the Centers for Medicare & Medicaid Services (CMS) released a final rule and the application that provides small employers with access to health insurance options for their employees. Beginning on October 1, 2013, small employers will be able to choose from a range of coverage options through the Small Business Health Options Program (SHOP) for their employees for coverage beginning on January 1, 2014.  The SHOP will offer a single point of entry for employers and their employees to apply for coverage, and if eligible, the employer may qualify for a tax credit worth up to 50 percent of the employer's premium contribution. View the full release here.



"Habilitative Services Under the ACA: A Crucial Issue for Children with Special Health Care Needs."   The Lucile Packard Foundation for Children's Health commissioned an issue brief, by Sara Rosenbaum, professor of health law and policy at the George Washington University School of Health and Health Services, which examines coverage of habilitative services for children under the "essential health benefits" provisions of the Affordable Care Act. 

The report concludes that, while provisions of the ACA have advanced access to habilitative service coverage in individual and small group markets, federal regulations issued in February 2013 may cause health plans to favor more comprehensive adult rehabilitative services over child habilitative services. The issue brief offers recommendations that may be useful to advocates monitoring state regulation of health plans.  The same issue is addressed in a public radio report, "For Kids with Chronic Conditions, a Looming Insurance Battle."

Family Voices, has been active in trying to strengthen regulations governing coverage of the ACA-mandated "habilitative services" benefit, both on its own and as part of the "HAB Coalition," (also on Facebook).  The HAB Coalition is conducting a survey of consumer experiences in getting coverage of habilitative services under their insurance plans.

Medicaid for former foster youth up to age 26.  The ACA allows children up to age 26 to remain on their parents' health insurance policies, and allows former foster youth of the same ages to retain eligibility for Medicaid if they were in foster care and were enrolled in Medicaid when they turned 18.  This week's blog of the Georgetown Center on Children and Families discusses the various issues involved in implementing this provision for former foster youth.  More information on ACA provisions of potential help to former foster youth can be found in a paper co-authored by (Family Voices Public Policy Co-Director) Brooke Lehmann, of which a summary can be found here.

More resources on ACA implementation:

 StateRefor(u)m, a project of the National Academy for State Health Policy (NASHP) and the Robert Wood Johnson Foundation, held a webinar last week on three states' methods for certifying health care plans for Exchange participation.  A recording of the webinar, including Q & A, is now available, as are the slides alone.  Also available are the following resources:

State Approaches to Qualified Health Plan Certification Chart, which shows how much authority each exchange or partnership state has in the various domains related to certifying health plans to be sold in an exchange. Includes links to source documents.

State and Partnership Exchange Policy Decisions Chart, which identifies various decisions states must make with respect to Exchange implementation, such as with the eligibility system will include Medicaid, how to approach consumer assistance; how to finance the exchange; and how much authority over insurance plans they will have.  Includes links to source documents.

Exchange Blueprint Chart/Where States Stand on Exchanges Map, two documents providing information   about which type of exchange will be in each state, some of the background on how each state came to that decision, and any future plans to change status.

Webcast on engaging and enrolling uninsured individuals.  Available here is a webcast of a session held by Families USA and Enroll America that discusses: (1) tactics for successfully engaging uninsured people, particularly communities of color, to get them enrolled in health insurance, and (2) best practices for raising public awareness about the health insurance options available under the ACA. 

Families USA Resource Center on Navigators and In-Person Assisters.  Families USA has created a Navigator and In-Person Assister Resource Center and people can sign up to receive updates on this topic. 

Other websites where one can get information and sign up for updates are:

1.     HealthCare.gov: This site is geared towards consumers and provides general information about the Marketplace and health insurance. Consumers can sign up for email and/or text message updates.

2.     Marketplace.cms.gov: This page has a wide variety of tools and resources to help you help people prepare to apply, enroll and get coverage in 2014. You can also sign up for updates by clicking on "Get updates." After entering your email address, check the box that says "Health Insurance Marketplace (Exchange)" under the "Outreach and Education" section near the middle of the page. This is the main avenue that CMS will use to communicate with interested stakeholders on Marketplace updates.

To submit comments or make inquiries, contact partnership@cms.hhs.gov.


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

Best, Janis & Brooke

Janis Guerney, Esq.

Brooke Lehmann, MSW, Esq.



CMS is happy to announce the availability of Health Insurance Marketplace webinars throughout the months of June and July.  These training opportunities are broken into two levels:

  • Level 1: Health Insurance Marketplace 101 (basic) - A one-hour high-level webinar overview of the accomplishments of the Affordable Care Act and a basic introduction to the Marketplace (Exchanges) highlighting who is eligible and how the Marketplace will work.
  • Level 2: Understanding the Health Insurance Marketplace (advanced) - A two-hour detailed review of the Marketplace (Exchanges), including eligibility, enrollment, plan structure, Medicaid expansion, and the streamlined application.

Please select the webinar that best suits your needs and then select the Registration Link that corresponds with the date to register for the webinar.  Please note that there is a limit of 200 people for each of the webinars and will be filled on a first come first serve basis; so we ask that you be flexible with your selected date.  However, more webinars will be added if demand is shown. The following tables list the available dates and times for the webinars:

Level 1: Health Insurance Marketplace 101


1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET



1:00 - 2:00 pm ET




Level 2: Understanding the Health Insurance Marketplace


1:00 - 3:00 pm ET



1:00 - 3:00 pm ET



1:00 - 3:00 pm ET



1:00 - 3:00 pm ET




For more information on these and other events hosted by the Centers for Medicare & Medicaid Services, email the CMS National Training Program at training@cms.hhs.gov.  Marketplace information and training materials for partners is available at Marketplace.cms.gov.