February 18, 2014

February 18 Washington DC Update


Washington DC Update 2/18/14

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

Greetings from Washington!  The big news last week was the enactment of bipartisan legislation to prevent a default on the nation’s debt. This week also saw the appointment of a new chairman for the Senate Finance Committee, the release of a Senate committee report on restraint and seclusion in our nation’s schools, and revelations that people are having trouble getting resolution of HealthCare.gov enrollment problems. Only 6 weeks until ACA open-enrollment season ends on March 31!

UPCOMING WEBINARS AND CALLS 

“Champions for Coverage” Call  On Wednesday, February 19, 2014 at 2:00 ET, the Centers of Medicare and Medicaid Services (CMS) will hold another call for those involved in helping people to enroll in health plans under the Affordable Care Act (ACA). Please submit any questions in advance regarding Marketplace outreach and education via email at Champion@cms.hhs.gov and include “Champion call question” in the subject line. 

Dial-In Number: (855) 258-3677 / Conference ID: 47040109.

Affordable Care Act Q& A  On February 20, 2014, at 1:00 pm-2:00 ET, the HHS/Center for Faith-Based and Neighborhood Partnerships is offering a webinar, Questions and Answers on the Health Care Law. Register here 

Webinar Series:  “A Practical Guide to Healthcare Reform: The ABCs of Eligibility under the ACA”  A series of free seminars is being offered every Wednesday, beginning March 5, from 2:00-3:30 ET, by Manatt Health Solutions. Intended for community-based organizations, in-person assisters, Navigators and others seeking to help individuals understand their health insurance options, the presenters in this five-part series will address rules that govern individual eligibility for Medicaid, premium tax credits and cost sharing reductions, and suggest strategies to inform consumers’ decisions when exploring their health coverage options. Manatt is also available to offer free trainings to groups of 50 or more on any of the five topics in the series. For more information or to schedule a training session, contact Arielle Traub at 212-790-4551 or atraub@manatt.com. Click here (scroll down to end of page) for information on the topic of each session and to register.

IN CONGRESS

New Chairman for Senate Finance Committee  On February 12, Senator Ron Wyden (D-OR) was formally selected as the new chairman of the Senate Finance Committee, replacing retired Senator Max Baucus (D-MT) who was confirmed as U.S. Ambassador to China. This is significant because the Finance Committee has jurisdiction over the Family-to-Family Health Information Center (F2F) grant program. At the same time, the Senate appointed Senator Mark Warner (D-VA) to the committee. The Finance Committee also has jurisdiction over Medicaid, Medicare, the Maternal and Child Health Block Grant (Title V), tax law, and trade law.

Seclusion and Restraints in Schools  On February 12 Senator Tom Harkin (D-IA), Chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, released a 54-page report outlining the findings of a committee investigation about schools’ practices around seclusion and restraint of students with behavioral problems, including those stemming from disabilities. Quoting from the committee’s press release:

The investigation sought to better understand the types of seclusion and restraints practices occurring in U.S. schools, and the obstacles faced by families seeking to stop the use of these practices or seeking restitution for harm caused by these practices. 

The Committee staff found that, under current law, a family whose child has been injured, experienced trauma, or, in the worst case, has died as a result of the use of seclusion or restraints practices in a school has little or no recourse through school procedures or the courts. In fact, the investigation found that only eighteen states currently require parents be notified about the use of seclusion or restraints.

The report describes ten cases from multiple states, and identifies certain commonalities found across cases and states.

The report’s recommendations will be reflected in legislation to be introduced soon by Senators Harkin and Chris Murphy (D-CT), the “Keeping All Students Safe Act.”  As outlined in the committee summary of the bill, the legislation would prohibit the use of:  seclusion in locked, unattended rooms or enclosures; mechanical restraints (e.g., Velcro straps, belts, or duct tape); physical restraints (when a staff member restrains the student with his or her body); and chemical restraints (the use of medications to subdue a student). Any restraint that restricts breathing would also be prohibited, along with aversive behavioral interventions that compromise health and safety. In May 2013, Rep. George Miller (D-CA) introduced a House version of this legislation. See this story in Disability Scoop. 

F2F Funding   [Updated short explanation.]  As detailed in an earlier Washington Update, a provision to extend and increase F2F funding is included in a bill reported out of the Senate Finance Committee that addresses Medicare physician reimbursement (“SGR” bill). The F2F provision is part of a package of health and human services “extenders” in that bill to extend expiring provisions of law.

Two House committees have also developed SGR bills – which do not include any extenders –and last week, the three committees announced that they had reached a consensus position on how to permanently address Medicare physician payments. This is a significant achievement because it solves a long-standing problem with physician reimbursement policy. At this time, however, the committees have not identified any “offsets” to pay for the cost of the new policy. Moreover, it is not known whether new Senate Finance Committee Chairman Ron Wyden (D-OR), see above, will go along with this deal.

It is not clear whether any final SGR legislation will also include the F2F extension and the other extenders that were in the Senate Finance Committee bill. Whether the extenders will be in the final package is likely to be a function of the cost of the legislation and the corresponding offsets to pay for it.

F2F Funding Bills   At this point, the F2F provision in the Senate Finance Committee’s Medicare physician-payment bill – providing five years of additional funding at $6 million per year – is preferable to the three-year extension of $5 million in the Menendez and Pallone bills. Nevertheless, cosponsorship of one of these bills is a means of expressing support for the F2F program. The House bill (H.R. 423) now has six cosponsors in addition to Rep. Pallone. The Senate bill (S. 423) has five cosponsors in addition Senator Menendez.

ACA NEWS and INFORMATION  [See below for ACA resources.] 

Unresolved ACA Problems  According to internal government data obtained by the Washington Post, there are tens of thousands of people who discovered that HealthCare.gov made mistakes as they were signing up for a health plan but who are unable to get their problems fixed. As related in this article, roughly 22,000 Americans have filed appeals with the government for correction of mistakes made by HealthCare.gov, such as charging too much for health insurance, steering them into the wrong insurance program, or denying them coverage entirely. But, at this point, the appeals are not being processed. In addition, an unknown number of consumers who are trying to get help by calling the health-care marketplace (rather than filing a formal appeal) are told that HealthCare.gov’s computer system is not yet allowing federal workers to go into enrollment records to change them, according to the Post’s sources inside and outside of government.

House Members Seek Investigations of Failed State Insurance Exchange Websites   According to this article in The Hill, several House Members are seeking investigations of Exchange state websites – in Oregon, Maryland, and Massachusetts – that have faced serious problems enrolling people in insurance plans.

On Wednesday, Representatives Andy Harris (R-MD) and Jack Kingston (R-GA) sent a letter to Health and Human Services Inspector General Daniel Levinson asking for an investigation into Maryland’s exchange. The same day, four Republicans on the House Energy and Commerce Committee, led by Rep. Greg Walden (R-OR), sent a letter to the Government Accountability Office (GAO) requesting a review of the $304 million in federal grants that Oregon received to build its broken website. (In Oregon, no one has been able to enroll online; all enrollments have been done through paper applications.)  These lawmakers are laying the groundwork to claw-back some of the state’s $304 million in grants if Oregon decides to abandon its state-run exchange and join the federal system.

REMINDERS of ACA and HealthCare.gov Changes:

  • Consumers may make some changes in insurance coverage before March 31. See this article from the Washington Post.
  • Improvements to HealthCare.gov
  • Ability to change application information  HealthCare.gov has been modified to allow applicants to report increases or decreases in income; add or remove household members; or report a change in address, a new pregnancy, or a gain or loss in health coverage.
  • “Looping” problem addressed  Improvements address the problem known as “looping” – applicants getting referred back and forth between HealthCare.gov and their state’s Medicaid agency website when eligibility determinations are inconsistent. Now, such applicants can be assessed for other benefits without the Medicaid determination – eligibility for Advanced Premium Tax credits, Cost-Sharing Reductions, and coverage in a Qualified Health Plan. More information is available at https://www.healthcare.gov/help/found-not-eligible-for-medicaid/.
  • Third-party funds may be used to supplement purchase of ObamaCare. According to this report from Reuters, CMS may strengthen its position on health plans accepting third-party payments to help consumers purchase insurance, such as payments provided under the 1990 Ryan White Act. CMS issued a clarification of federal rules:  “Federal rules do not prevent the use of Ryan White funds to pay for health care plans,” and added that it had issued guidance “encouraging issuers and Marketplaces to accept such payments.”

FEATURED RESOURCES ON THE ACA

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 http://www.fv-ncfpp.org/tools-and-resources/aca/. We welcome suggestions for resources to post on the webpage. Please send your ideas to arichey@familyvoices.org .

FV/NCFPP ACA Blog  The most recent blog posting from NJ family leader Lauren Agoratus can be found on this page.

Follow HHS. ACA information is available from HHS via Facebook, Google + and Twitter. You can sign up here for Marketplace email and text message updates, or visit the Marketplace page for CMS partners to sign up for Marketplace email updates geared towards partners and to download CMS resources, training materials, or learn about partnership opportunities.

“Comparing Health Plans’ Benefits and Coverage Summaries” The National Disability Navigator Resource Collaborative (NDNRC) has released its first fact sheet – “Comparing Health Plans’ Benefits and Coverage Summaries” – which is designed to inform navigators and other enrollment specialists about what people with disabilities need to look for in the Summary of Benefits and Coverage sections on HealthCare.gov. A list of upcoming fact sheets is available here. The NDNRC website (http://www.nationaldisabilitynavigator.org/) also has news and resources designed to support groups providing enrollment assistance to consumers with disabilities, including the “Guide to Disability for Healthcare Insurance Marketplace Navigators.”

Resources from Marketplace.cms.gov

http://marketplace.cms.gov/help-us/2-partner-with-us.html:

  • Helping consumers with the application process
  • Helping consumers with eligibility and plan selection
  • Helping consumers with casework
  • Helping consumers with eligibility and the application process
  • Helping consumers with payment and eligibility issues

Immigration Information on HealthCare.gov

Here are helpful links on HealthCare.gov regarding immigration:

  1. Information on Eligible Immigration Status Types
  2. More Information on Eligible Immigration Status Types
  3. Information for Naturalized or Derived Citizens
  4. Information on Immigration Documentation and how to correctly put it into the application

OTHER RESOURCES

Disability and Weight Gain  The Centers for Disease Control and Prevention (CDC) has released several fact sheets on prevention of obesity in people with disabilities. See http://www.cdc.gov/ncbddd/disabilityandhealth/briefs.html.

Overviews of ADA Requirements  The Disability Rights Section of the Civil Rights Division of the U.S. Department of Justice recently released two documents focusing on the 2010 revised requirements of the Americans with Disabilities Act (ADA). The documents provide overviews, information, and staff training resources.

Click here to view a document intended to help entities understand new rules for wheelchairs, mobility aids, and other power-driven mobility devices.

Click here to view a document to assist entities in effective communication between those with disabilities and those without disabilities. 

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Collection of ACA stories  Family Voices is collecting anecdotes about people’s experiences with the ACA – both positive stories and information about problems – so that we can inform policy makers. Please share your story, and encourage others to share theirs, at http://www.familyvoices.org/action/share. Please indicate in the first line that it is a story about the ACA.

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Please help us make the Update more useful to you. Does it provide the right amount of information?  What parts are helpful and not so helpful?  Please let us know!

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

Yours truly,

THE FAMILY VOICES POLICY TEAM

Janis Guerney, Esq.

202-546-0558 

jguerney@familyvoices.org  

Brooke Lehmann, MSW, Esq.

202-333-2770 

blehmann@familyvoices.org  

Lynda Honberg

lhonberg@familyvoices.org

NOTEPast issues of the Update appears can be found on the home page of the Family Voices website  by scrolling down the "News Feed" items.