September 15, 2014

September 15 Washington DC Update

September 15 Washington DC Update

Washington DC Update  9/17/14

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

Greetings from Washington!  Congress hopes to finish up its work this week so that Members can go home to campaign for re-election. Meanwhile, the Department of Health and Human Services is busy trying to resolve discrepancies in income information for Marketplace insurance subsidy applicants. Information about how to help those applicants, and more, can be found in this Update.


Early Hearing Detection and Intervention

Thursday, September 18, at 1:30-2:30pm ET

The National Center for Hearing Assessment and Management (NCHAM) is sponsoring a webinar, Promoting EHDI Pals, intended for EHDI Coordinators, EHDI staff, Audiologists, and Hospital Newborn Hearing Screening Program Managers. To register, click here. If you have questions about this webinar, please contact Derek Saunders at 


House Expected to Take up Short Term Spending Bill

The House of Representatives is expected to vote this week on a short-term spending bill, or “continuing resolution” (CR), for Federal FY 2015, which starts on October 1.  This would leave the Senate with little to no opportunity to make changes and send it back before the House leaves for its pre-election recess, probably at the end of this week.  Under the CR, expected to last through mid-December, most programs would receive "level funding" (i.e. the same amount of funding they received in the last fiscal year). At that point, the Congress (which will include "lame ducks" - those not returning in the next session due to retirement or loss of re-election)  mostly likely will either pass a CR to last the rest of the fiscal year (through September 2015), or pass one lasting long enough to let the next Congress decide what to do. 

Emergency Medical Services for Children (EMSC)

Last week, the Senate passed legislation to reauthorize the EMSC program, which, among other things, provides grants to states to improve their emergency medical services for children. The bill was sponsored by Senators Robert Casey (D-PA) and Orrin Hatch (R-UT). The House was scheduled to take up the Senate bill under “suspension of the rules,” meaning it is expected to pass. Family Voices endorsed this legislation. For more information, see this press release from Sen. Casey’s office.

CHIP Hearing

On Tuesday, retiring Senator Jay Rockefeller (D-WV) chaired his final hearing in the Finance Committee’s Subcommittee on Health Care. The Affordable Care Act (ACA) reauthorized the Children’s Health Insurance Program (CHIP) through FY 2019, but provided funding only through FY 2015. See the Finance Committee website for more information about the hearing.

Hearing on Overcoming Persistent Barriers to Economic Self-Sufficiency for People with Disabilities

On Thursday, the Senate Committee on Health, Education, Labor, and Pensions (HELP), chaired by retiring Senator Tom Harkin (D-IA), will hold a hearing on “Overcoming Persistent Barriers to Economic Self-Sufficiency for People with Disabilities.” Visit the HELP Committee website for more information, including testimony and live video the day of the hearing.


Income Data Matching and Citizenship/Immigration Update

Income-related issues. On Monday, the Federal Health Insurance Marketplace (Marketplace) began sending notices to consumers who have an income-related data matching issue. The deadline for response is September 30, 2014. Failure to respond may affect the cost of an individual’s monthly premium, deductibles, copays and co-insurance, or tax liability.

According to the Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS):  “Income-related data matching notices are being sent in English and Spanish and will provide straightforward instructions on how consumers should submit the necessary information to the Marketplace.... Those individuals receiving a letter referencing September 30 should log into their account and select their current application to upload their documents. They can also mail their information to our consumer center. To facilitate timely processing, consumers mailing in a copy of their documents should include the bar code page from the notice with their documents. Consumers may also contact our call center at 1-800-318-2596 to see what documents they need to submit and check whether the Federal Marketplace has received their information.”

CMS notes that consumers often have more up-to-date information than the data on which HHS relies. “For example, the Marketplace verified income by checking 2012 tax return information, but a consumer could have switched jobs since those returns were filed. Just because CMS is double-checking data and requesting more documentation, doesn’t mean that a consumer has provided false information or that he or she is ineligible for help paying for coverage or health services – it simply means that the information on their application doesn’t match what’s in trusted data sources and therefore has to be verified.”  About 279,000 households, representing 363,000 individuals, need to send in supporting information. For local assistance, consumers can visit Find Local Help on

Update on citizenship issues. In August CMS sent letters to about 310,000 Federal Marketplace consumers who had not submitted any outstanding citizenship or immigration documents after numerous requests. They received hundreds of thousands of documents in response to the September 5 deadline, resulting in a decrease from 966,000 cases as of the end of May to 115,000 as of September 14. Those whose issues are unresolved will receive notices saying their last day of Federal Marketplace coverage is September 30, 2014. Those who submit information that confirms their eligibility after the deadline may be eligible for a special enrollment period to enroll in coverage. For more information, visit Questions or Concerns? Contact

CMS Approves Special Enrollment for Wisconsin Residents Who Lost Coverage

Last week, federal officials announced that Wisconsinites who lost health coverage because of changes in the state's Medicaid program will have until November 2 to obtain insurance on the federal exchange (Marketplace). It is suggested that eligible individuals contact the Marketplace federal call center at 1-800-318-2596 to apply. For more details, see this CMS press release.

Grants for ACA Enrollment Outreach to Minority Populations

On September 11, the Department of Health and Human Services (HHS) Office of Minority Health (OMH) announced $3.2 million in new grants to 13 organizations to help support health coverage enrollment of racial and ethnic minorities. The new “Partnerships to Increase Coverage in Communities” (PICC) Initiative will help identify, inform, and enroll minority populations in the Health Insurance Marketplace, Medicaid, and CHIP. The PICC grantees will also provide information on financial assistance, education, and translation services to support health insurance enrollment. The PICC Initiative awards will support organizations, partnerships, and coalitions in developing culturally competent and linguistically appropriate services designed to reach racial and ethnic minorities and underserved communities. The PICC Initiative awardees are in the following cities:  Los Angeles; Boston; Philadelphia; San Antonio; Chicago; Houston; Miami; Seattle; Washington, DC; Little Rock, AR; Concord, NH; Ridgeland, MS; and Birmingham, AL. Additional information about the PICC Initiative and grant awardees is available here.

Grants to Community Health Centers

On September 12, Health and Human Services Secretary Sylvia M. Burwell announced $295 million in Affordable Care Act funding to 1,195 health centers in every U.S. State, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin to expand primary care services. These additional funds should enable health centers to increase access to comprehensive primary health care services by hiring new staff, staying open for longer hours, and expanding the care they provide to include new services such as oral health, behavioral health, pharmacy, and vision services. It is expected that the funding will help health centers reach an estimated 1.5 million new patients nationwide, including over 137,000 oral health patients and more than 38,000 mental health and substance abuse patients. For more information, see this HHS press release.

More on Navigators, Consumer Application Counselors (CACs), and Other Assisters

As reported in last week’s Update, the Department of HHS recently announced $60 million in Navigator grant awards to 90 organizations in states with federally-facilitated and state partnership Marketplaces. This press release outlines some of the criteria that these grantees must meet: 

  • Navigator grantees must maintain a physical presence in the Marketplace service-area, so that consumers can easily access face-to-face assistance.
  • Navigator grantees are required to be trained on and comply with strict security and privacy standards to ensure that consumers’ personally identifiable information (PII) is protected, as was the case last year. In no case will Navigators obtain a consumer’s PII without the consumer’s consent.
  • In addition to quarterly and annual reporting, Navigators will also be required to submit to HHS weekly progress reports detailing their progress and activities in the communities they serve.
  • Based on feedback from the assister community, HHS is incorporating new elements into this year’s required training, such as a course on advanced Marketplace issues with detailed information on topics such as how to help college-age students enroll in coverage and re-enrollment. HHS is committed to providing Navigators with on-going technical assistance and training opportunities throughout the year.

The list of HHS Navigator awardees, additional information about Navigators and other Marketplace resources are available here. The Navigator Awardee List with summaries is available here.


Interesting Studies on Children’s Insurance Coverage

Rate of Uninsured Children Unchanged. A recent survey conducted by the Urban Institute showed that the percentage of children without insurance nationwide remained the same – about 7 percent – after implementation of the ACA. Most of the uninsured children are actually eligible for Medicaid or CHIP. See this article from Kaiser Health News or this Washington Post “Wonkblog” post for more details.

Medicaid and CHIP Especially Critical for Rural Children. The children’s advocacy group First Focus released a study indicating that children who live in rural areas are 24 percent more likely than kids who live in urban areas to rely on CHIP and Medicaid for health care. In 2012, 47 percent of rural children were covered by public insurance compared to 38 percent of urban children. And the share of rural children who rely on Medicaid and CHIP has been climbing rapidly in recent years, from 28 percent in 2000 to 47 percent in 2012.

Information about Health and Developmental Screenings

The CDC recently released an MMWR (Morbidity and Mortality Weekly Report) Supplement, “Use of Selected Clinical Preventive Services to Improve the Health of Infants, Children, and Adolescents —United States, 1999–2011.” To access the Executive Summary and full report, click here. See also this article from Disability Scoop. The findings indicate that many children are not receiving the preventive screenings they should.

FEATURED RESOURCE (and request for assistance)

Medicaid Waivers

Complex Child Magazine has embarked on an effort to make information about Medicaid waivers for children accessible to the average person through a website, On that website, the About Waivers page explains the different types of Medicaid waivers and how they work. The project’s first phase is complete: a full list of current Medicaid waivers for children. The next phase is to create individual state pages that provide additional information and links for each program (target date November 1, 2014). The third phase will be to provide advocacy information to preserve these programs and link families who can work together to do so (target date January 1, 2015).

Once complete, the resource should provide a comprehensive source of information about all Medicaid waivers for children, including 1915(c) HCBS waivers, 1115 demonstration waivers, TEFRA/Katie Beckett programs, and state-based programs.

Request for assistance. The magazine has asked that advocates help them verify the accuracy of and gather more information about state waiver programs. They can be contacted via or Susan Agrawal at