October 10, 2014

October 8 Washington DC Update

Washington DC Update 10/08/14

{Don’t forget to check out the Family Voices/NCFPP ACA webpage
and the most recent NCFPP blog post on coverage of children “aging out” of Medicaid.}

Greetings from Washington! Congress remains in recess, but the Supreme Court is back in session and there is speculation about whether they might take up a case regarding the health care reform law. Read about this and more in this week’s Update. But first…

Twitter Chat today – from the Children’s Hospital Association and MomsRising:

On Wednesday, October 8th from 1:00 - 2:00 p.m. EDT, the Children's Hospital Association is partnering with MomsRising through a #WellnessWed Twitter Chat to engage parents who have a strong interest in child health around the topic of children with medical complexity. MomsRising is an online network of advocates that reaches over three million people and takes on the most critical issues facing women, mothers and families by educating the public and mobilizing massive grassroots actions. The Children’s Hospital Association will participate on the #WellnessWed Chat through its advocacy Twitter handle, @speaknowforkids. For details on how to participate, see the end of this Update.


A Conversation about Telehealth and Children with Special Health Care Needs
Wednesday, October 8, 3:00-4:00 pm ET
Family Voices of California is presenting this webinar, at which speakers from The Children's Partnership, Center for Connected Health Policy, and UC Davis Children's Hospital will discuss the definition of telehealth, how it can be used to improve care for children with special health care needs, and how advocates can help promote its wider adoption. Learn more and register here.

By the way:  Stories Sought on Children Who Received Health Care through Telehealth: The Children's Partnership would like to interview families of children with special health care needs who have experience with telehealth/telemedicine. With a grant from the Lucile Packard Foundation for Children's Health, the Partnership is working with the Center for Connected Health Policy and UC Davis to examine how telehealth can be used to improve care for children with special health care needs. Families willing to share their story should contact Jacob Vigil at jvigil@childrenspartnership.org, or (310) 260-1220.

Medicaid Innovation Accelerator Program (IAP): Virtual Meeting
Thursday, October 9, 12:30-2:30 pm ET
Conference Call: 1-877-267-1577
PIN: 991 395 924

In this webinar, participants will learn more about the IAP and have an opportunity to share feedback on the types of technical assistance and tools that would be helpful in accelerating Medicaid innovation efforts. Participants will also be asked to comment on the IAP’s potential program priority areas and learn how the IAP can support states interested in accelerating innovation in the area of reducing substance use disorders (SUDs).

For more information on the existing body of federal guidance and information related to delivery system innovation, go to the IAP page on Medicaid.gov. Also, check out the Fact Sheet called Making the Case for IAP. Questions or comments may be directed to MedicaidIAP@cms.hhs.gov.

Enroll America Webinar Series on Open Enrollment
To address questions about the upcoming open enrollment period, Enroll America is sponsoring a series of webinars this month:

Outreach 2.0: Applying Lessons Learned When Connecting With Specific Uninsured Communities (Young Adult, Latino, and African American)
Wednesday, October 8, 2:00 pm ET

This webinar will address effective outreach and “in-reach” strategies identified during the first open enrollment period (OE1). Presenters will provide examples of data-informed tactics and unique solutions to challenges when conducting in-reach and outreach work. This webinar will focus specifically on how to engage young adult, Latino, and African American populations. Click Here to Register.

Successful Recipes to Reach Rural Communities
Tuesday, October 14, 4:00 pm ET
This webinar will cover things to consider when conducting rural outreach and will highlight practicable and replicable outreach strategies used during the first open enrollment period to engage the rural uninsured. Click Here to Register.

Building Capacity: Partner Engagement and Grassroots Organizing
Save the Date: Thursday, October 16, 1:00 pm ET
Grassroots organizing was a key factor in connecting individuals to marketplace, Medicaid, or Children’s Health Insurance Program coverage during the first open enrollment period (OE1). This webinar will present data-driven grassroots and partner engagement strategies to help maximize outreach and enrollment efforts, including how to build and sustain a volunteer program, increase in-person help in your community, and multiply your effect through innovative partner engagement work. This webinar is appropriate for community organizations working on outreach and enrollment. Click Here to Register.

Health Insurance Literacy: Key Considerations for Enrollment Stakeholders
Save the Date: Monday, October 20, 2014, at 2:00 pm ET

Working with Agents and Brokers
Save the Date: Thursday, October 23, 2014, at 4:00 pm ET

Enroll America’s Communicator’s Guide: How to Message Get Covered, Stay Covered
Save the Date: Monday, October 27, 2014, at 2:00 pm ET

Plan for Success! Monitor and Measure for Guidance
Save the Date: Wednesday, October 29, 2014, at 2:00 pm ET

Enroll America will also be sponsoring a blog series at #Ready4OE2.


ACA Litigation and Implementation Update
Thursday, October 16, 3:00 - 4:15 pm ET

The Network for Public Health Law is hosting this webinar, which will provide an update on Affordable Care Act (ACA) implementation, including states’ decisions regarding Medicaid expansion and health insurance exchanges, as well as provisions regarding public health. Experts will also discuss the legal challenges to the ACA, some seeking to enjoin the law and others to enforce it. The webinar will be a live webcast of a session from the 2014 Public Health Law Conference. Register here.


“Beyond the Basics” Review Series (updated)
As detailed below, the Center for Budget and Policy Priorities (CBPP) is conducting refresher webinars from its “Beyond the Basics” series. These webinars are intended for those working on the implementation of the Affordable Care Act (ACA) including navigators, assisters, Certified Application Counselors (CACs), and others assisting consumers apply for coverage in a Marketplace.

UpdateThe CBPP has updated the content that will be covered in each presentation of its four-part Beyond the Basics of health reform refresher course in October. Please be sure to review the updated content that will be presented in each webinar. If you have already registered for a webinar, you will remain registered on that presentation day. If you cannot join the webinar, a video recording of the webinar will be made available at the Beyond the Basics website at www.healthreformbeyondthebasics.org. Registration for each of the sessions is now open. Note that space is limited. Register here for any of the webinars below.

Eligibility for Coverage Programs
Thursday, October 9, 2014
2:00 pm - 3:30 pm ET
This webinar will present an overview of ACA coverage options, and provide a detailed discussion of eligibility for premium tax credits – including how offers of employer-sponsored insurance can affect eligibility – as well as how premium tax credits are calculated. 
How to Determine Household Size and Income
Thursday, October 16, 2014
2:00 pm - 3:30 pm Eastern
This webinar will detail the rules used to determine household size and what counts as income when determining eligibility for premium tax credits and Medicaid. 

Premium Tax Credit Reconciliation and the Marketplace Renewal Process
Thursday, October 23, 2014
2:00 pm - 3:30 pm ET
This webinar will discuss how premium tax credits are recalculated when a person’s circumstances change and how the advance payments people have received in 2014 are reconciled when they file their 2014 tax returns. We will also describe the 2015 renewal process for premium tax credits, cost-sharing reductions and qualified health plans.
Plan Design and Plan Selection
Thursday, October 30, 2014
2:00 pm - 3:30 pm ET
This webinar will cover health plan design, including cost-sharing charges in Marketplace plans, eligibility for cost-sharing reductions, and how cost-sharing reductions affect costs for consumers. We will also discuss how to evaluate Marketplace plans based on cost-sharing and plan design, and will walk through the plan selection process. 

SAMHSA Listening Session: Improving Community Mental Health Services
Save the Date:  Wednesday, November 12, 9:00 am – 5:00 pm ET
The Substance Abuse and Mental Health Services Administration (SAMHSA) will be holding a listening session about criteria development for the Demonstration Programs to Improve Community Mental Health Services, established under Section 223 of the Protecting Access to Medicare Act of 2014. The law seeks to create certified community behavioral health clinics to focus on improving outcomes by increasing access to community-based behavioral health care, expanding the availability and array of services, and improving the quality of care delivered to people with mental and/or substance use disorders. Participants can attend the listening session in person or via webcast. Registration is required; registration information is forthcoming. Location: SAMHSA, Sugarloaf Conference Room, 1 Choke Cherry Road, Rockville, MD 20857


CHIP Funding
Congress is in recess until but child health advocates are nonetheless gearing up to try to persuade lawmakers to extend funding for the Children’s Health Insurance Program (CHIP) for an additional four years. The program is authorized through FY 2019, but funding is provided only through FY 2015. A group of organizations, including Family Voices, the American Academy of Pediatrics, the Children’s Hospital Association, and March of Dimes, have signed a letter to Congress about the CHIP extension.

ABLE Act Legislation
Other legislation that might be taken up during the lame-duck session of Congress include the “Achieving a Better Life Experience (ABLE) Act,” (see the October 1 Washington DC Update) and the resolution of ratification of the U.N. Convention on the Rights of Persons with Disabilities (see the September 24 Washington DC Update).


ACA Court Cases

The first Monday in October marks the beginning of the Supreme Court’s term, and health law followers are waiting to see if the Court will take up a case involving tax subsidies provided to purchase health insurance pursuant to the Affordable Care Act (ACA). The issue is whether the language of the law allows subsidies only in states running their own exchanges, and not in states with a federally-facilitated exchange.

As explained in the July 30 Washington DC Update, two federal circuit courts of appeal issued opposite holdings on this issue in July. One of these courts granted a rare “en banc” rehearing, meaning that all of its 13 judges will take up the case. The plaintiffs in the other case appealed to the Supreme Court. The Supreme Court has discretion about whether to hear most types of cases, and a “split in the circuits” often will prompt the Court to take up a case involving that issue. In this situation, however, many court observers doubt that the Court will take up the case this term, given that the D.C. Circuit Court has yet to hear its case en banc. See this article from Politico.

Meanwhile, on Tuesday, an Oklahoma federal district court (lowest-level federal court) held, in agreement with the D.C. Circuit Court, that tax subsidies provided to purchase insurance cannot go to residents of states with a federally-facilitated insurance exchange. The administration is expected to appeal the decision. See this article from Talking Points Memo.

Cancelled Insurance Plans

During initial implementation of Affordable Care Ac (ACA), there was controversy surrounding President Obama’s claim that people could keep their health insurance if they liked it, since some plans were being cancelled by insurers. The administration then urged states to allow insurers to continue to offer plans that were not compliant with the law’s minimum standards. About half the states did so, and many insurers continued to offer such plans, which were often less expensive than plans that met the ACA standards for essential benefits. Now some of those insurers are sending cancellation notices to their customers, in some cases because the insurers have determined that it is more profitable to sell higher-priced plans meeting the law’s requirements, and in some cases because states are no longer permitting sales of noncompliant plans. It is unclear exactly how many people will be affected. Read more in this article from Kaiser Health News.

Application Inconsistencies

As reported by HHS in its weekly ACA bulletin, consumers who received a notice from the marketplace letting them know that there was an income inconsistency with their application were required to respond by September 30. For consumers unable to respond by the deadline, healthcare coverage is not expected to be cancelled, but their monthly premiums may go up or their tax credits may be taken away. Additional information about how to resolve an inconsistency is available through this HHS blog.

WORTH REPEATING:  People who already have insurance through the federal Marketplace will be automatically re-enrolled unless they take action (see this post from the Georgetown University Center for Children and Families blog) while those enrolled in Medicaid will have to re-enroll.

And REMEMBER these important dates: 

November 15, 2014. Open Enrollment begins to apply for, keep, or change coverage.

December 15, 2014. Enroll by the 15th for new coverage that begins on January 1, 2015. To change plans, enroll by the 15th to avoid a lapse in coverage.

December 31, 2014. Coverage ends for 2014 plans. Coverage for 2015 plans can start as soon as January 1st.

February 15, 2015. This is the last day to apply for 2015 coverage before the end of Open Enrollment.

For more information about enrollment dates, effective dates and special enrollment periods, click here.


“No Wrong Door” Grants
[From AUCD’s Legislative News in Brief]

The Administration for Community Living, Centers for Medicare and Medicaid Services, and Veterans Health Administration have announced awards to 25 states to develop state plans to develop a plan to create a single statewide “No Wrong Door” (NWD) access system to long-term services and supports (LTSS) for all populations and all payers. Many states are expected to build upon and improve their existing Aging and Disability Resource Centers (ADRC), LTSS access points, and “Balancing Incentive Program” efforts to better serve all populations of individuals needing LTSS.

Nominations for Public Members of the Interagency Autism Coordinating Committee
[From AUCD’s Legislative News in Brief]

The Department of Health and Human Services has announced the opening of nominations for public members of the Interagency Autism Coordinating Committee. The committee was established by the Combating Autism Act and reauthorized by the Autism Collaboration, Accountability, Research, Education and Support Act of 2014. Those eligible for nomination include leaders or representatives of major autism spectrum disorder (ASD) research, advocacy and service organizations, parents or guardians of individuals with ASD, individuals on the autism spectrum, healthcare and service providers, educators, researchers and other individuals with professional or personal experience with ASD. Nominations are due November 14, 2014. For information on how to submit a nomination, click here.

Research and Training Center on Family Support
[Thanks to Faye Manaster]

The University of Illinois at Chicago (UIC) has been awarded a $4,375,000 grant to develop a research center on family support. The UIC Department of Disability and Human Development (DHD) was awarded a 5-year grant by the National Institute on Disability and Rehabilitation Research (part of the U.S. Department of Education) to fund a Research and Training Center on Family Support. The Center’s goals are to define the state of science on family support of people with disabilities, generate new knowledge in critical policy areas, and implement a vision for policy and practice in family support through a national family support resource center. According to its director, the Center will focus on the needs of families across ages and disabilities, and from diverse racial and ethnic backgrounds, and “… will push knowledge forward on how disability related policies and practices impact family members, which is often ignored in policy discussions.”


ACA Resources

Tool to Help Families Select the Most Appropriate Health Insurance for Children with Special Health Care Needs
[Thanks to Diana Autin]
The Children’s Specialized Hospital in New Jersey has created an online tool (http://www.childrens-specialized.org/insurance-education) to help parents of children with special/complex medical needs choose the best health public or private health insurance plan for their child. The website provides parents with questions to ask and a tool to capture information about the unique medical needs of their family. It also provides a glossary of terms commonly used in the health insurance industry.

Dental Benefits and Exchanges
A new blog post about dental coverage through the exchanges has been added to State Refor(u)m (National Academy for State Health Policy). The post examines how three state-based exchanges – California, Washington and Connecticut – implemented the pediatric dental essential health benefit in 2014 and changes to dental benefits that will be made for 2015 open enrollment. It also provides many links on the topic. State-specific information on oral health and dental benefits can be found in this chart and additional resources can be found here.

Other Resources

Worth Repeating:  CMS FAQs: Identification of Medicaid Beneficiaries’ Third Party Resources and Coordination of Benefits with Medicaid and CHIP (updated September 11, 2014). http://medicaid.gov/Federal-Policy-Guidance/Downloads/FAQ-09-04-2014.pdf


October 8 Twitter Chat on Children with Medical Complexity

On Wednesday, October 8th from 1:00 pm – 2:00 pm ET, the Children's Hospital Association is partnering with MomsRising through a #WellnessWed Twitter Chat to engage parents who have a strong interest in child health around the topic of children with medical complexity. MomsRising is an online network of advocates that reaches over three million people and takes on the most critical issues facing women, mothers and families by educating the public and mobilizing massive grassroots actions. The Children’s Hospital Association will participate on the #WellnessWed Chat through its advocacy Twitter handle, @speaknowforkids.

Children's hospitals, clinical experts, patient families, partner organizations, and others aim to educate thousands of people about issues related to children with medical complexity and engage those people around pursuing better health care solutions for these kids.

How to Participate in the #WellnessWed Twitter Chat

This chat will be a LIVE event, so please join us a few minutes before 1:00 p.m. EDT and do the following:

1. Sign into your Twitter account.

2. Click on the hyperlink https://twitter.com/hashtag/wellnesswed to direct you to the chat.

3. MomsRising will begin the chat promptly at 1:00 p.m. EDT by asking for participants to identify themselves – that’s YOU, so let us know when prompted that you’re participating!, after which MomsRising will ask the first question.

4. In addition to watching for Speak Now for Kids’ (@speaknowforkids) answers to each question, you’re strongly encouraged to share your own insightful responses by posting a message (a.k.a. “tweet”) with the phrase #WellnessWed. Sample tweets are included below.

5. You’re also encouraged to “retweet” our messages and those from other users.

Note:  You must insert #WellnessWed in every message (a.k.a. “tweets”) you post, so everyone can see it!

Sample Tweets

Hours leading up to the Twitter Chat (October 8th)

Learn more about kids w/ medical complexity during today's #WellnessWed chat at 1pm ET/12pm CT  http://bit.ly/WellnessWed

What is a kid w/ medical complexity? Learn more 1pm ET today via #WellnessWed chat w/ @speaknowforkids: http://bit.ly/10-8chat

During the Twitter Chat (October 8th, 1:00 p.m. – 2:00 p.m. EDT)

Did u know many children w/ medical complexity have 2+ serious health conditions?  Learn more @ http://bit.ly/ACEKidsAct #WellnessWed

1/25 of all U.S. kids has a complex medical condition. #WellnessWed

#Parents of kids w/ medical complexity balance their own employment w/ their child’s medical needs & cost of care. #WellnessWed

 #Medicaid primarily finances health care for kids w/ medical complexity. #WellnessWed

How can you make a difference for these kids? Become a champion for children’s health @ http://t.co/agGT5DMUed. #WellnessWed