November 26, 2013

November 26 Washington DC Update

Washington DC Update 11/26/13 

{Don’t forget to check out the Family Voices/NCFPP ACA webpage!}

Greetings from Washington!  We DC dwellers survived the detonation of the “nuclear option” (a Senate rule change made by breaking the Senate rules), but Obamacare is still causing consternation. Due to the problems with the website, the administration has extended the enrollment deadline to December 23 for insurance coverage to begin on January 1. But the administration has announced that the website is now functioning much more smoothly. Read more below under “ACA News.”


National Discussion on Mental Health  On December 3, 2013, from 12:30 to 2:00 p.m. ET, the Office of Juvenile Justice and Delinquency Prevention in the U.S. Department of Justice, in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA), will present “Creating Community Solutions:  How to Connect to the National Discussion on Mental Health.” Panelists will identify ways to bring together mental health and juvenile justice systems to address the needs of youth by using the Creating Community Solutions approach. The Webinar will focus on how to build on existing community engagement activities to increase collaboration among community partners. Register here.

Champions for Coverage call   On Wednesday, December 4, at 2:00 p.m. ET, the Centers for Medicare and Medicaid Services (CMS) will hold another informational call for organizations that have joined the Champions for Coverage program and for national stakeholders and organizations interested in helping with Marketplace outreach and education. People are encouraged to submit questions in advance of the call via email ( - refer to “Champions for Coverage Call” in the subject line).

Call number (800) 837-1935          Conference ID:  15399660

Reminders from CMS: We encourage you to check out the new information for consumers at and sign up for Marketplace email and text message updates. Please visit our Marketplace page for CMS partners to sign up for Marketplace email updates geared towards partners and to download CMS resources, training, or learn about partnership opportunities.

Heads up: Save the date for the second Champion call in December currently scheduled for Wednesday the 18th at 2:00 p.m. ET.

Indian Health 101  On Monday, December 9, at 3:00 p.m. ET, this webinar will provide an overview of the Indian health care delivery system and the government’s trust responsibility to provide health care to Indians pursuant to treaties and federal statutes. The speaker will be Robert J. (Jim) Lyon, CAPT USPHS Intergovernmental and External Affairs Group/ Division of Tribal Affairs Center for Medicaid and CHIP, CMS. The webinar is sponsored by the Administration for Native Americans within the Administration for Children and Families, in partnership with CMS. Register at

Beyond the Basics of Health Reform The next installment of the Center on Budget and Policy Priorities’ webinar series will take place on Wednesday, December 11, at 2 p.m. ET. This webinar will provide answers to frequently asked questions from the series. A half hour will be dedicated to each of the following topics:  Plan selection and Enrollment, including cost-sharing and other features of plan design; Determining Household Size and Income; and Transitions in Coverage. The webinar will feature real-life scenarios to illustrate how health reform's new coverage options will work for individuals and families, and there will be time for questions. Space is limited. Register at


F2F Funding  UPDATED  The Family Voices policy team has been working with key Members of Congress to try to get an F2F funding extension included in must-pass legislation. The most likely legislative “vehicle” for the bill is the “health extenders” package - a group of provisions, mainly in Medicare and Medicaid, that tend to get reauthorized every year along with the legislation to maintain Medicare reimbursement levels to physicians (known as the SGR or “doc fix” bill). An SGR bill will be considered by the Senate Finance Committee on December 12.

The likelihood of getting an F2F funding extension will be greatly enhanced if more Members of Congress support these bills, particularly if there is bipartisan support.

Background  Federal funding for Family-to-Family Health Information Centers (F2Fs) was authorized only through FY 2013, so F2Fs will cease receiving grant funds at the end of May 2014 (the end of the FY 2013 grant cycle) unless legislation is enacted to extend funding. Senator Robert Menendez (D-NJ) and Representative Frank Pallone (D-NJ) have introduced bills (S. 423 and H.R. 564) that would extend F2F funding at the current level of $5 million per year through FY 2016.

The Senate bill currently is cosponsored by Senators Sheldon Whitehouse (D-RI), Al Franken (D-MN), Amy Klobuchar (D-MN), Elizabeth Warren (D-MA), and Christopher Coons (D-DE). The House bill is cosponsored by Representative David Cicilline (D-RI) and Rep. Tony Cardenas (D-CA).


[Please see above for information about webinars and teleconferences related to the ACA.]

More Time to Sign Up  The administration announced last week that it would give people an extra week to sign up for insurance policies that would go into effect on January 1. Now people will have until December 23 to enroll and until December 31 to pay their premiums.

The administration also announced that next year, the timeline would be moved so that insurers have longer to figure out premiums for 2015 policies, and consumers have more time to select a plan. The 2014 sign-up period was originally scheduled to run from October 15, 2014, to December 7, 2014. It will now run from November 15, 2014, to January 15, 2015. Some have noted that this change moves the commencement of the enrollment period to a date after the 2014 mid-term congressional elections.  The administration has said that is has made multiple improvements to the website and expects it to be able to handle much more traffic by November 30. Among other things, the administration has created a "queuing system" to be used in times of intense website traffic. If more than 50,000 users are attempting to access the website at once, users can either wait to be granted access or choose to receive an email notifying them when the site is less busy. The users that chose to wait will be given a link putting them at the front of the line to access the website once traffic has decreased.

The administration also announced that “direct enrollment” with insurance companies will be possible soon, allowing consumers to bypass the website for part of the enrollment process. According to an article on, customers could go to an insurer’s website to learn about plan offerings. They would then be referred to to determine their eligibility for a federal tax credit, and then directed back to the company site to purchase a plan. Customers not eligible for tax subsidies have been able to use direct enrollment since October 1, but the fixes put in place Tuesday expand the process to all customers seeking insurance on the individual market.

Restrictions on Provider Networks  Concerns have emerged about the scope of provider networks under some of the health plans being offered in the exchanges. In order to contain costs, some insurers are significantly restricting networks, excluding some major teaching hospitals and children’s hospitals. See this story in the Washington Post.

FAQs on the ACA and Families with Mixed Immigration Status  The National Immigration Law Center has developed a list of frequently asked questions on mixed-status families and the ACA.


NEW BLOG from Family Voices!  The second installment of the Family Voices ACA monthly blog, written by Lauren Agoratus - the mother of a child with multiple disabilities, the NJ Coordinator for Family Voices, and the southern coordinator in NJ’s Family-to-Family Health Information Center - is about Medicaid Expansion under the ACA.

Updated Subsidy Calculator  The Kaiser Family Foundation has updated its health reform subsidy calculator to provide premium estimates in all 50 states plus the District of Columbia for people who buy coverage through the new state health insurance marketplaces. The calculator is also available in Spanish. By entering their ZIP code, income, age, family size, and other factors into the calculator, consumers can get estimates of the tax subsidies and insurance premiums available to them if they were to purchase insurance through the marketplaces (exchanges). The calculator now takes into account the latest decisions from states on whether to expand Medicaid eligibility under the law.

Information on Insurance Policy Cancellations and Consumer Rights   CMS has developed a site to help people whose insurance policies have been cancelled:

Worth repeating:

Family Voices/NCFPP Webpage on the ACA  Family Voices and the National Center for Family/Professional Partnerships (NCFPP) have a frequently updated and searchable ACA resource page which can be found at This page offers information for both families and family leaders to help them understand the ACA’s impact on CYSHCN and their families, and to help others to understand it as well. We welcome suggestions for resources to post on the webpage. Please send your ideas to

Indiana Family Voices ACA Guide Indiana’s Family Voices has created this resource guide to answer basic questions about purchasing insurance under the ACA and to help families choose the most suitable insurance plan for them and their children with special health care needs.

Indian Health Services ACA Webpage  The new IHS ACA webpage ( is now online. It provides ACA-related information specific to American Indians and Alaska Natives (AI/AN) and answers many questions being asked by these communities.

Follow HHS  ACA information is available from HHS via Facebook, Google + and Twitter.


NOTE:  The Washington Update will not be issued next Tuesday due to the Thanksgiving holiday and congressional recess.

If you have any suggestions about how to make the Update more useful to you, please let us know!  Does it provide the right amount of information?  What parts are helpful and not so helpful?  And, as always, please feel free to contact us with any questions.

We hope you have a wonderful, safe, and healthy Thanksgiving with friends and family.

Yours truly,


Janis Guerney, Esq.


Brooke Lehmann, MSW, Esq.


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