December 16, 2010
This week, the Finish Line Flash passes along a number of resources aimed at strengthening Medicaid and CHIP and looking ahead to health reform implementation. We share some model comments on CMS’s proposed 90/10 match for Medicaid systems improvements, link you to a recent discussion of eligibility and enrollment enhancements, suggest a potential source of Medicaid savings through pharmacy benefit management, and pass along news of an upcoming demonstration of Wisconsin’s prototype Exchange website.
Opportunity to Comment
Support for Proposed Rule on 90/10 Systems Match—As you may be aware, CMS recently proposed a rule that would allow states to claim a 90% federal match for investments in their Medicaid eligibility and claims systems—see Tricia Brooks’ Say Ahhh! post. CCF has drafted comments in support of the rule and is looking for sign-ons from other organizations. Check out the comments here. For more information, dial in to today’s Finish Line conference call at 1:00 pm Eastern at 866-910-4857, code 609561#.
Strengthening Public Programs
NASHP Enrollment Briefing Video Available—Last week, the National Academy for State Health Policy hosted a discussion of lessons learned from the Maximizing Enrollment for Kids project, featuring Cindy Mann and CCF’s Jocelyn Guyer among other speakers. Participants shared how some of the project states have worked to redesign eligibility and enrollment to strengthen current programs and prepare for health reform implementation. Find video of the briefing as well as presentation slides at the link above.
Study Identifies Potential Medicaid Drug Savings—The Lewin Group, in a report commissioned by the Pharmacy Care Management Association, estimated the potential savings that each state could achieve through greater use of pharmacy benefits management in Medicaid. While the source of the study shows some clear conflict of interest—the report suggests states should make greater use of the funders’ services—it nonetheless highlights a potential source of Medicaid savings that advocates and state policymakers may want to consider.
Health Reform Resources
What Does an Exchange Look Like?—State Coverage Initiatives will host a webinar on Tuesday, December 21 from 2:00 – 3:30 pm Eastern that will allow participants to view a prototype website developed by the Wisconsin Department of Health Services to support one-stop eligibility determination for the state’s Medicaid and exchange populations. The webinar will also cover key policy and design issues related to exchange eligibility and enrollment. The webinar represents a great early chance to see what an Exchange website would look like for users and hear some of the decisions that states must make in establishing them.
As always, please feel free to contact any of us—or any of your fellow grantees using the listserve—with any questions you have.
December 8, 2010
The Finish Line Flash this week shares holiday-focused enrollment materials from California, a new report on health reform’s fiscal impact on states, another condemnation of Texas’ leaders suggestion that the state drop out of Medicaid, and notice of a webinar that looks at the effects of 12 month continuous coverage on continuity of care.
Outreach and Enrollment
Health for the Holidays—Finish Liners in California have produced a series of materials—a flyer and four cards—to promote enrollment in Medicaid and CHIP. They’re distributing the materials through state lawmakers and grassroots partners, urging local residents to give a child in their community “health for the holidays.” The flyer and cards use Narrative messages, the content is completely transferrable to other states and communities, and the images allow advocates to customize the materials for varying constituencies.
Health Reform Resources
States to Gain Billions from Health Reform—In a report commissioned by First Focus, Urban Institute researchers looked at the fiscal impact on states of the Affordable Care Act. They worked to calculate the net effect, examining both the increased spending for new enrollees and savings from shifting some adults from Medicaid to exchange coverage, reductions in uncompensated care costs, and greater federal support for mental health services. While the report does not calculate net savings for each state, it shows where savings are likely to emerge. These potential areas for savings should serve as a reality check for any state-specific estimates that show large costs to a state in implementing health reform.
Texas Op-Ed Translates Medicaid Policy into Politics—This op-ed by a Texas health policy expert uses our recommended messaging to highlight the dire consequences of dropping out of Medicaid for kids, families, the state’s health care workforce, taxpayers and the economy. But it goes a step farther, connecting these harms with politics and concluding that “a governor who was elected on a pro-business platform would have a hard time defending” the resulting loss of nearly $1 trillion in lost economic activity
Webinar To Share Data on 12 Month Continuous Coverage—The State Health Access Reform Evaluation project will present a webinar on the impacts of 12 month continuous coverage for children. It will share the effects of continuous coverage on children’s use of services in California. The webinar will take place on Thursday, December 16, at 12:30 pm–register at https://cc.readytalk.com/cc/schedule/display.do?udc=sjptg5phxxdt. While this partially conflicts with next week’s Finish Line call, the webinar will be recorded and available on SHARE’s website for viewing later.
As always, please feel free to contact any of us—or any of your fellow grantees using the listserve—with any questions you have.
December 1, 2010
This week, the Finish Line Flash week brings you a comprehensive toolkit for assessing a state’s kids coverage programs, a great opinion piece squashing the idea of a state dropping out of Medicaid, and a useful study that shows similar experiences on key measures between kids with private and public coverage.
NASHP’s Self-Assessment Toolkit for Max Enroll—As part of its efforts under the Maximizing Enrollment for Kids grant, the National Academy for State Health Policy has developed a toolkit to help states evaluate their kids coverage programs. The toolkit guides states through an assessment of their enrollment and retention processes and procedures to identify strengths, weaknesses and opportunities for improvements. Completing the toolkit requires the involvement of state officials and other stakeholders, so undertaking it can be a great way to build your relationships with key decisionmakers and help show them how removing enrollment barriers can benefits kids, families, and the state. Getting a commitment to completing the assessment can be a first step toward eliminating these barriers.
Dropping Out Doesn’t Add Up—An encouraging reminder in Kaiser Health News that efforts to withdraw from Medicaid may be politically problematic but are nearly fiscally and practically impossible. This commentary uses the Texas example to highlight the same catastrophic consequences identified in the Say Ahhh! blog post on Wyoming’s Medicaid withdrawal analysis. It also provides a helpful reminder that kids’ advocates will have plenty of natural allies in pushing back against cuts to Medicaid, so this is a great time to start building or reinforcing relationships with providers, seniors’ groups, local government officials and others who stand to lose.
Study Compares Public, Private Coverage in Oregon—In a study published in the Maternal and Child Health Journal, researchers asked parents about their experiences with public and private coverage. They found no clear qualitative consensus regarding a superior type of insurance coverage. Public coverage drawbacks included stigma and limited provider options, while concerns about high costs and uncovered services were associated with private coverage. In a quantitative analysis, the authors found children with public coverage to have higher odds of experiencing unmet specialty care needs. Those with private coverage, however, had greater odds of unmet prescription drug and mental health counseling needs.
As always, please feel free to contact any of us—or any of your fellow grantees using the listserve—with any questions you have.
November 17, 2010
The Finish Line Flash this week links you to a great new state health reform implementation resource from NASHP and an updated 50 state collection of online program information. We also encourage you to comment on a set of NAIC model laws on ACA consumer protections.
Health Reform Resources
NASHP’s State Refor(u)m—The National Academy for State Health Policy has established a website to collect health reform implementation materials from state policymakers. The site has workplans and timelines, fiscal analyses, federal grant applications, legislative language, and more. In addition to organizing the material by type, it also arranges them to match the priorities identified in the NASHP report State Policymakers’ Priorities for Successful Implementation of Health Reform. Since every state has similar responsibilities in implementing the Affordable Care Act, this site can help states learn from each other and avoid reinventing the wheel in each step of the implementation process.
State Program Information
Online Info on Low-Income Benefit Programs—The Center on Budget and Policy Priorities has updated its compilation of links to online sources of information on key low-income benefit programs. You’ll find links to each states’ online policy manuals, applications, and basic program information for the five major benefit programs including Medicaid, CHIP, SNAP, TANF and Child Care Assistance. A useful resource to make sure you know where to find info from your state or to compare what is available in other states.
Opportunity for Comment
NAIC Model Laws on Consumer Protection—The National Association of Insurance Commissioners is working to produce a set of model laws on the consumer protections that went into effect on Sept. 23—these include the ban on pre-existing condition exclusions for children, allowing dependent coverage up to age 26, ending cost-sharing for preventive services, and others. In the link, see Exposure Drafts on the right. The model laws can help clarify state insurance regulators’ authority to enforce these provisions. Your comments on the models can help make sure the federal provisions serve as a floor that allows states to go further, not a ceiling that limits the protections a state can establish for consumers. For a more complete explanation, see Sabrina Corlette’s post on Say Ahhh!
November 4, 2010
This week, the Finish Line Flash focuses on federal rulemaking and grant opportunities that may affect your state’s Medicaid program and Exchange development. We urge you to comment on waiver transparency rules and bring you news on federal support—new grants and matching funds—for both Medicaid programs and Exchanges as states work to implement the ACA.
Comments Sought on Waiver Transparency—One part of the ACA you may not have paid much attention to is its requirement for new rules on gathering public input on Medicaid waivers—but now is the time to engage with this issue. CMS recently proposed this new set of waiver transparency rules and is seeking comments on them by Nov. 16. Now is a great time for state advocates to share their experiences with the Medicaid waiver process or to voice their opinion on what the rules should say. CCF and the Waiver Task Force have helped make it easy to do so—click here for a set of recommendations. You can sign on to these comments here or modify them and submit them as your own. Read Joan Alker’s blog post on the topic here.
Early Innovator Grants for Exchange System Pioneers—Last week, CMS announced the availability of grants for states to reward the development of IT systems needed to operate the Exchanges and make their eligibility and enrollment processes consumer-friendly. The two-year grants will go to up to 5 states or coalitions of states whose systems can serve as models for other states as they develop their own Exchanges. Applications are due by December 22 and grants will be awarded by February 15, 2011. See Tricia Brooks’s post on the grants on Say Ahhh!
90/10 Medicaid Match for New Technology Systems—This week, CMS proposed a new rule that would allow states to claim a 90 percent federal match for Medicaid technology investments, including both eligibility systems and claims processing systems. Currently, the 50 percent administrative match rate applies to most such expenditures. The higher match is intended to help Medicaid systems modernize in anticipation of health reform implementation. The rule proposes that the 90 percent match for the system development would decline to a 75 percent match for system maintenance after 2015.
October 27, 2010
The Finish Line Flash this week alerts you to a webinar on enrollment and retention next week as well as a useful new brief from Kaiser and The Children’s Partnership on enrollment systems under health reform. We also highlight a great state-specific health reform checklist prepared by Finish Liners in Texas.
Enrollment and Retention Webinar—Researchers with the Child Policy Research Center at Cincinnati Children’s Hospital Medical Center will share findings on duration, churning, and turnover among children in Medicaid. A panel of experts will respond and comment, including CCF’s Tricia Brooks, NASHP’s Alan Weil, and two California Medicaid officials. The webniar will take place Wednesday, November 3, from 2:30 – 3:30 pm Eastern. Register at https://www3.gotomeeting.com/register/146423310
Health Reform Resources
Kaiser and TCP Explain ACA’s Enrollment System Requirements—A new paper from the Kaiser Commission on Medicaid and the Uninsured and The Children’s Partnership examines strategies for states to improve their enrollment systems as they move forward in ACA implementation. It describes the features needed to meet ACA standards, provides examples of effective current state practices, and makes recommendations on building modernized, ACA-ready systems. A great guide for advocacy on this issue!
Health Reform Checklist—Finish Liners at CPPP in Texas have created a very useful checklist on health reform implementation in their state. They divide provisions into those that require state action, those that provide for state options, and those that will take effect without state action. In addition, they identify the top five priorities for health reform for the state. If the document inspires you to create a similar one for your own state, let your Finish Line or Narrative team know so they can lend a hand.
October 20, 2010
This week, the Finish Line Flash includes news of the ACA’s Consumer Assistance grants, a model exchange fact sheet from California, and an announcement of a Commonwealth Fund webinar on state implementation of exchanges.
HHS Announces Consumer Assistance Program Grants—HHS this week announced about $30 million worth of grants to states to support consumer assistance activities. The grants will help states—and in some states, partnering non-profits—aid consumers as they deal with insurers. They will also allow states to systematically collect and report information on the challenges that consumers face in getting and using insurance. The link above lists the states that applied for grants (all who applied received some funding); it also lists which state office will receive the grant and summarizes planned activities.
Health Reform Resources
100% Campaign Produces Exchange Explainer—The California Finish Liners put together a handy 2-page guide to the concept of a health insurance exchange and how it will work in their state. While California has a bit more certainty on its exchange since it has passed the legislation creating it, the guide could help inspire a similar piece for your state.
Commonwealth to Host Webinar on Exchanges—On Thursday, November 4, at 2 pm Eastern, the Commonwealth Fund, the National Academy for State Health Policy, and Women in Government will hold a webinar to address the major challenges to successful implementation of exchanges. Speakers, including Timothy Jost of Washington and Lee University and state officials from California and Illinois, will present policy options and recommendations for federal and state officials, as well as provide an update on the status of the regulatory process and state implementation. Register at https://cc.readytalk.com/cc/schedule/display.do?udc=4vwzb70vtvs6
October 14, 2010
The Finish Line Flash this week includes the latest news on child-only plans from HHS Secretary Kathleen Sebelius, an announcement of a call with CMS, and three model media pieces—a news story from North Carolina, and editorial from Iowa, and a letter-to-the-editor from Utah.
Sebelius Urges States to Take Action on Child-Only Plans—HHS Secretary Kathleen Sebelius reached out to state insurance commissioners on child-only plans in a letter to their national association. In addition to calling on insurers to keep their promises regarding pre-existing coverage exclusions for children, the Secretary made it clear that state regulation can help make the ACA’s ban on such exclusions a reality. As described in the letter, states have a variety of choices for encouraging private plans to offer child-only coverage and can adopt buy-ins for public coverage to provide another option for families. Read CCF’s statement on the letter. And please contact your Finish Line or Narrative team members if we can be helpful in communicating with your state’s insurance regulator on this issue.
CMS Call on Puerto Rican Birth Certificates—Over the summer, you may have heard of a new law in Puerto Rico that invalidates birth certificates the Commonwealth issued in the past—see a July Say Ahhh! post from Jon Peacock of Wisconsin. This week, CMS will hold a conference call to discuss how the birth certificate issue affects Medicaid and CHIP applications. CMS Family and Children’s Health Programs Group Director Vikki Wachino and her staff will discuss how state officials, advocates, and community-based organizations can help assure that individuals receive the coverage for which they are eligible. The call will be Thursday, October 14, from 12:00-1:00 pm Eastern. Dial 1-877-267-1577 and the meeting ID is 8500.
NC Advocates Employ Smart Budget Messaging—This North Carolina article illustrates the recommended budget messages at work. The quote from the NC pediatrician reminds readers of the consequences for kids if the state relies on cuts alone. Then, the quote from Mandy Ableidinger at Action for Children North Carolina reminds them that investments in health care, education, and family income are smart budget decisions proven to deliver results for North Carolina kids and families. This powerful approach – highlighting the harm that would come from bad budget decisions, then offering a better, smarter way – is a great way to make the case for continued investments in kids.
Iowa Paper Sees Coverage Changing for the Better—In this editorial, the Des Moines Register calls it a mistake for President Obama to have pledged that those who like their coverage will be able to keep it under health reform. Health insurance, it observes, is always changing and usually not at the choice of consumers. Nonetheless, the piece concludes health reform will bring changes for the good to an industry that has been “broken for generations” and end some of the worst practices of insurance companies. The editorial demonstrates a great way to show strong support for health reform while acknowledging that it is not perfect.
Utah Doc Stands Up for Health Reform—This letter-to-the-editor from a Utah pediatrician is a solid example of the recommended health reform messaging approach. It starts strong, with an assertion that reform is a big win for kids, then reminding readers that lots of Utah kids don’t need to wait, because they’re already eligible for CHIP or Medicaid coverage. At less than 200 words, this letter is a great reminder that the recommended health reform messages can get the job done even when space is at a premium.
October 6, 2010
This week, the Finish Line Flash brings you two effective editorials that respond to insurers’ actions on child-only plans, one from Texas and another from Kentucky. It also connects you to a useful examination of the challenges exchanges will face and a great blog post on the truth about state Medicaid spending. Finally, there’s an updated reminder for booking Finish Line Conference hotel rooms.
Kentucky Paper Makes the Case for the Coverage Mandate—This editorial clearly explains the business rationale behind the individual mandate, using insurers’ recent cutoffs of child-only policies as an example. With that in mind, the editorial then explains why President Obama chose to not establish a single payer system and concludes that the health reform law may not be perfect but is a definite improvement. This way of explaining the purpose behind the individual mandate is one approach that advocates in conservative states can take to better explain the concept to audiences whose primary concern is cost containment.
Texas Paper Takes Insurers to Task on Child-only Plans–This strongly-worded editorial slams Texas insurance companies for their recent decisions to cease offering child-only policies in that state. It outlines the pledges of support that insurance companies made in the past for ending denials of coverage for children with pre-existing conditions and says they have now “reneged. . .and washed their hands” of the issues. The editorial closes by reiterating their support for health reform and promises that 2014 will bring better news for kids with pre-existing conditions.
Health Reform Resources
Commonwealth Fund Examines Exchange Challenges—In a new report, Timothy Jost raises eight questions about the implementation of state health benefit exchanges. The report provides context for each of the questions and importantly, makes recommendations on each of them. Along with CCF’s Implementing Health Reform: Key Questions for States, this report can help state advocates frame the key decision points as states begin to move forward on exchanges.
How Has Medicaid Spending Really Affected State Budgets?—On Say Ahhh!, CCF’s Martha Heberlein looks at recent trends in Medicaid spending. Contrary to what many of us hear about state Medicaid expenses being “out of control,” she finds that state spending has actually decreased in the last couple of years. This is due to ARRA’s increased federal match rates and in spite of the fact that the program is doing its job to cover many more people during the recession.
Finish Line Conference RSVPs—Last week, we reminded you to make reservations for the Finish Line Conference; thanks to those who have. The conference hotel is no longer accepting direct bookings, but if you still need to make a room reservation, just contact us directly: please e-mail Liz Arjun at email@example.com or Karina Wagnerman at firstname.lastname@example.org.
September 29, 2010
The Finish Line Flash this week reminds you of the upcoming Finish Line Conference in Washington, shares a blog post from from Wisconsin on the September 23rd ACA provisions, and connects you to a new report from Community Catalyst and CSS on consumer assistance under health reform.
RSVP Now for the Finish Line Conference—A gentle reminder to make your plans (if you haven’t already) to attend the Finish Line Conference scheduled for November 9-10 in Washington, DC. CCF and Spitfire staff are hard at work planning a productive day for Finish Line and Narrative grantees. We’ll discuss moving forward in covering eligible kids and how health reform impacts our work, among other topics.
To RSVP, please e-mail Liz Arjun at email@example.com or Karina Wagnerman at firstname.lastname@example.org. In addition, those who will be attending the From Vision to Reality health reform meeting should also register online at http://www.statestrategiesforimplementation.org/.
Finish Liners: Please book your room for your entire stay, including any attendance at From Vision to Reality, at this link. Use the following codes:
Group ID: 18509
Group Contact Password: Georgetown
Narrative Grantees: After you RSVP, we will book your rooms for you.
All Attendees: Please RSVP by October 4.
WCCF Blogs on Sept. 23rd—Jon Peacock of the Wisconsin Council on Children and Families wrote a great blog post recently about health reform provisions that went into effect on September 23. He starts with basic information about the provisions, then localizes the issue with a quote from the WCCF Executive Director and directs readers to a new report from CCF which has additional good information about September 23 reforms. Jon finishes up by bringing the reader back to the present with a reminder that eligible but uninsured Wisconsin kids don’t have to wait for health reform to be in place before they get care, since they can sign up for BadgerCare right now.
Health Reform Resources
Consumer Assistance Recommendations from CSS and Community Catalyst—Most of us have heard about the ACA’s consumer assistance grants but may not be quite sure how these programs work. In a recent report, the Community Service Society and Community Catalyst help explain how states can best provide consumer assistance in health care coverage. They identify four different models and profile seven different programs that are currently providing assistance. Using lessons from these efforts, the report makes recommendations for states on how to effectively implement consumer assistance, either with the grants available this year or under the health reform Navigator program to come.
September 23, 2010
This week, the Finish Line Flash links you to a brief but effective letter-to-the-editor from California, a handy list of ACA enrollment policy provisions from Families USA, and a great, animated video clip from the Kaiser Family Foundation that explains health reform in under 10 minutes.
California Finish Liner Stresses Kids Don’t Have to Wait–This letter from Kelly Hardy of Children Now responds to a recent Sacramento Bee editorial on health reform. The Bee editorial said that it may take time to see the early benefits of health reform, but Kelly reminds readers that California kids don’t have to wait until 2014 because many already qualify for coverage. She reminds policymakers how they can help, but then she creatively goes one step further by offering other Bee readers an idea of how they can help, too. Her ask for readers is one effective way of making this topic easy to understand for people who aren’t involved in advocacy on a regular basis but may be able to reach kids or their parents.
Health Reform Resources
Enrollment Policies Summarized—Families USA recently released a fact sheet that covers the enrollment policy provisions of the Affordable Care Act. It provides bullet point summaries of the parts of the law that aim to make enrollment procedures more effective and efficient. It separately covers those provisions that encourage coordination between public programs and the exchanges and those that deal with each coverage source exclusively.
Kaiser Animation Explains Reform—A new, nine-minute video called Health Reform Hits Main Street from the Kaiser Family Foundation explains health reform in a very understandable way. It lays out the problems the Affordable Care Act seeks to address as well as the law’s provisions using animated characters and voice-over from Cokie Roberts. Worth a watch and worth sharing!
September 15, 2010
The Finish Line Flash this week comes just in time to remind you of tomorrow’s release of Census data that will include numbers on health insurance rates. It also links you to two recent blog posts from Say Ahhh!—one on the September 23rd provisions and another on a new grant opportunity for states.
Census Day is Tomorrow—As you know, September 16 is the day when the Census Bureau will release data from its 2009 Current Population Survey (CPS). This will include estimates of the rates of public and private health insurance coverage as well as uninsurance rates for adults under 65 and children. Preliminary analysis suggests that private coverage will have dropped substantially for both children and adults, with public coverage expanding to keep the rate of uninsured children relatively stable. Adults, though, may see historically high uninsurance rates. Of course, we’ll have to confirm this analysis by examining the actual numbers that are released tomorrow morning.
The release of the numbers presents another opportunity to discuss the success of Medicaid and CHIP in covering children and the need to keep both programs strong. It also reinforces the need for health reform to cover those who have lost private coverage. After the September 3rd release of the Urban Institute’s Medicaid and CHIP participation rate data, several of you mentioned on the listserve that you would be using tomorrow’s opportunity to talk about both sets of numbers. CCF plans to release a statement on the data—please feel free to use it as a model. A preliminary draft is available here, but please note that it is subject to change based on the actual numbers.
Finally, note that the Census Bureau plans to release yet another set of data on September 28—the American Community Survey (ACS). The ACS is a richer data source than the CPS and CCF plans to perform state level analysis which we will, of course, share with you.
As always, please contact your Finish Line or Narrative team members if we can provide any assistance in making use of any of these data sources.
New Posts on Say Ahhh!—Be sure to check out CCF’s blog for a post from Dawn Horner that summarizes the Affordable Care Act provisions that go into effect for plan years beginning after September 23, the first of a series of posts on this topic. You may also be interested in passing along to your state agency contacts Tricia Brooks’ post on a new grant available to states to help in streamlining access to health coverage and other benefits.
September 1, 2010
This week’s Finish Line Flash includes a reminder about Friday’s relaunch of the “Connecting Kids to Coverage Challenge”, some tools from Spitfire about taking up the challenge, a link to the Healthy Kids facebook page in Oregon where you can see pictures from a recent event there where Governor Kulongoski announced that Oregon was taking up the Challenge and last but not least, a great article from the Salt Lake Tribune about the impact of new provisions in the health reform law on Utah families.
To access the Finish Line section of CCF’s website, use the username childhealth and the password finishline.
Connecting Kids to Coverage Challenge
“Connecting Kids to Coverage Challenge” Relaunch- This Friday, Secretary Sebelius will talk about the importance of focusing our efforts on enrolling the 5 million eligible but unenrolled children into coverage. At the Friday event, Secretary Sebelius will be joined by Jenny Kenney from the Urban Institute who will be talking about new data she is releasing about the number of eligible but unerolled children in Medicaid and CHIP. CCF is hosting a special state partner call tomorrow with Jenny and Donna Cohen Ross from CMS about her data and about Friday’s event. Please let us know if you didn’t receive the notice about the call. In the meantime, Spitfire has prepared some materials to help you generate attention on the Challenge and the Coaches Campaign that was announced in states in August.
“Connecting Kids to Coverage Challenge”- This letter, originally built for the Narrative Project, can be used to reach out to local policymakers, business leaders, school officials, nonprofit executives or other prospective partners about accepting the Connecting Kids to Coverage Challenge. HHS is re-launching the challenge (formerly the Secretary’s Challenge) on Friday and announcing a wide range of national partners committed to finding and covering eligible but unenrolled kids. This letter can help you begin a similar conversation in your community.
“Get Covered, Get in the Game”- This letter, also built for the Narrative Project, makes it easier to get local coaches and athletic directors involved. It also offers help, so coaches see the campaign as doable, as well as valuable. And with a few tweaks, it can also be adapted as a letter to a state coaches association or education agency.
Oregon Governor Kulongoski Accepts the Challenge
Governor Kulongoski Accepts the Challenge– Last week, Governor Ted Kulongoski (D-OR) accepted the Challenge to enroll all of Oregon’s eligible but unenrolled children into coverage at an event where he was joined by Secretary Sebelius, coaches, parents and school and community partners. Notably, Oregon has enrolled 54,000 children over the last year since the Health Kids Program over a year ago. Check out the Healthy Kids Facebook page for more information about the event.
Health Reform & Utah Families
Utah Kids Win in Reform– This Salt Lake Tribune article positions kids as clear winners in health reform. Using the story of 11-year old Samantha, who lost her father’s employer sponsored coverage in March, this article shows how the law benefits all children, not just those with chronic health conditions like Samantha. This great example from our Utah Finish Line team is a reminder that stories like this are unfolding in your communities where kids are clearly benefitting from health reform, and highlighting them can be an important and effective part of shaping the public understanding of reform
August 26, 2010
The Finish Line Flash this week passes along a great op-ed from Texas and links you to two handy health reform resources—a summary of eligibility and enrollment provisions and an updated look at how states are beginning to move forward with implementation.
Texas Businessman Calls for Investment in Kids—In a strongly argued opinion piece, Children’s Defense Fund – Texas Advisory Board Chairman Lan Bentsen makes the economic case for protecting children’s health and education as Texas faces a budget crisis. In addition to laying out the costs of cutting support for kids, he uses strong messaging that calls for a balanced approach to solving the crisis and urges leaders to do the smart thing by supporting children’s growth and development.
Health Reform Resources
Eligibility and Enrollment Provisions in the ACA—The Children’s Partnership and the Kaiser Commission on Medicaid and the Uninsured recently released a summary of the provisions of the Affordable Care Act that impact eligibility and enrollment for Medicaid, CHIP, and subsidized Exchange coverage. The summary points out that the law requires enrollment systems that are consumer-friendly, coordinated, simplified, and technology-enabled.
How Does Your State Compare to Others in Health Reform Implementation?—The National Conference of State Legislatures has been continuously updating its web page on state actions to implement health reform. It tracks both legislative and executive branch actions, so you can find information on bill introductions as well as task forces or other groups convened by executive order. If your state is one of those yet to act, the links may be helpful in providing a model for getting started.
August 18, 2010
This week, a quick Finish Line Flash shares the successful media coverage Colorado Finish Liners earned when they noted an enrollment milestone, links you to a new kids health web page from NASHP, and reminds you of two new resources from NILC.
Colorado Governor and Finish Liners Celebrate Enrollment Gains—In the midst of state budget crises, it can be hard to get policymakers to recognize the bright side of increases in enrollment—more kids getting coverage who otherwise wouldn’t. But Finish Liners in Colorado were able to do just that—they joined Governor Ritter in celebrating the milestone of adding 100,000 kids to Medicaid and CHIP coverage since 2007. The event was a great way to spread the word on the success of the programs and gave supporters a chance to take credit. The event won extensive print and broadcast media coverage–including TV coverage of the event’s race to the Finish Line (be sure to click on the video on the right).
NASHP Children’s Health Insurance Web Page—NASHP has organized a web portal to collect its publications and other resources on coverage for kids. It includes information on state CHIP programs and other initiatives to cover children as well as a section on health reform and children.
In Case You Missed It
NILC Materials on Immigrant Coverage—Prior to this week’s CCF State Partners Call, we shared two recent fact sheets from the National Immigration Law Center. One expands upon the July CMS guidance on CHIPRA’s option for states to cover legally residing immigrant children and pregnant women present less than five years. The other provides an overview of how immigrants are included in health reform. Whether or not you were able to join the call, both are useful documents for understanding recent developments in covering immigrant children.
August 11, 2010
The Finish Line Flash this week focuses on yesterday’s partial extension of increased FMAP for states. You’ll find links to estimates of the additional funding it means for Medicaid programs as well as state economies and a model op-ed to thank supporters.
FMAP Extension Approved—President Obama yesterday signed legislation to continue increased FMAP through June of 2011. The FMAP increase that had been scheduled to end in December will instead continue at a lower level—the 6.2 percentage point increase for all states will decrease to 3.2 percentage points in January and to 1.2 percentage points in April. States will continue to receive additional funds if their unemployment rates reach specified levels.
–The Center on Budget and Policy Priorities has estimated the total amounts each state will receive under the legislation.
— The Center for American Progress used a Families USA method to estimate for each state the increased economic activity that has resulted from the enhanced federal Medicaid funding to date.
–As Narrative grantees know, Spitfire Strategies has produced a model letter-to-the-editor that you can use to thank Congressional supporters of the legislation.
August 4, 2010
This week, the Finish Line Flash includes a memo from Ed at Spitfire that introduces you to a set of messaging recommendations for talking about children’s issues that Drew Westen prepared for First Focus. We also link you to the recent funding announcement for Exchange Planning Grants, a helpful timeline for state exchange development, and a powerful editorial from Alaska on the governor’s veto of a kids’ coverage expansion.
Exchange Planning Grants Available—HHS recently opened the opportunity for states to apply for Exchange Planning Grants under the Affordable Care Act. Each state is eligible for up to $1 million for planning and establishing the exchanges that ACA envisions for every state. A pre-application conference call will be held on August 5 at 2:00 pm Eastern (dial (888) 995-9574; Passcode: 3223160). Applications are due by September 1.
Memo from Ed—Click the link to find a memo from Ed Walz on a set of messaging recommendations from Drew Westen. Ed notes how the Narrative message principles are reflected in the recommended strategies—find them here or through the link in the memo.
Health Reform Resources
SCI Commissions Exchange Planning Timeline—State Coverage Initiatives has released a timeline to guide many of the tasks necessary for states to establish a health insurance exchange. The timeline was created by the former executive director and chief financial officer of the Commonwealth Health Insurance Connector Authority, the Massachusetts exchange which serves as a model for ACA’s American Health Benefit Exchanges.
Alaska Op-Ed—This op-ed in the Bristol Bay Times by Alaska State Senator Bettye Davis criticizes Governor Sean Parnell’s recent veto of legislation to strengthen Denali KidCare. It uses maintaining-the-gains messaging to explain exactly which services Alaska’s children and pregnant women will go without, as a result of the Governor’s veto, and ends with a strong, memorable closing. The piece also showcases the power of smaller, local media outlets. If you have written a great op-ed but your state’s largest newspaper has no space to publish it tomorrow, consider submitting it instead to a small newspaper to reach the same audience through a different venue.
July 28, 2010
The Finish Line Flash this week links you to a number of important evaluations of children’s health advocacy—two evaluation briefs on the Finish Line project itself and a look at the Covering Kids and Families initiative. We also share a great series of one-pagers from Colorado, an effective op-ed on FMAP from Pennsylvania, and a reminder of a back-to-school webinar set for tomorrow.
Finish Line—Led by Mathematica Policy Research in collaboration with its subcontractors, the Urban Institute and the Center for Studying Health System Change, Finish Line’s evaluation component aims to inform decision makers in states and at the national level about promising coverage strategies and programs. The evaluators have released two briefs based on site visits to Finish Line states: one focused on state based advocacy and another on strategic engagement of policymakers. Gene Lewitt and Liane Wong of the Packard Foundation blogged about the new briefs on Say Ahhh!
CFK—Evaluators from Mathematica, Health Management Associates, and the Urban Institute also recently released an evaluation of the Covering Kids and Families initiative sponsored by the Robert Wood Johnson Foundation. The evaluation documents and assesses the strategies of CKF grantees and evaluates their effectiveness. It found that grantees were successful in influencing Medicaid and CHIP policies and that streamlined enrollment procedures led to increased enrollment.
Faces and Facts Series from Colorado—Finish Liners in Colorado have produced a series of appealing one-pagers that make the case for expanding kids coverage. The briefs employ an effective combination of family stories and relevant data points to create a compelling message. They cover the need for and benefits from coverage, the basics of Medicaid and CHIP, national health reform, and other topics. The Coloradans sent the briefs in a packet to help educate candidates for office; adapted to your state they could be used in the same way or many others.
Pennsylvania FMAP Op-Ed—Pennsylvania Partnerships for Children CEO Joan Benso placed an opinion piece that lays out the stakes for her state of the pending FMAP extension. She points out that many areas of the state budget will be pressured if Congress does not extend the increased Medicaid match rate—affecting education and human services as well as health services.
CMS Webinar on Back-to-School Outreach—A quick reminder that CMS will host a webinar tomorrow, July 29, to discuss strategies to reach eligible children as the school season gets started. You can register online for the session, which will take place at 2:30 pm Eastern.
July 21, 2010
In the Finish Line Flash this week, we link you to a handy web-based health reform timeline from Community Catalyst and share two model opinion pieces, one on FMAP and the other on health reform’s benefits for kids.
Health Reform Resources
Implementation Timeline—Community Catalyst has produced a web-based timeline that shows important health reform milestones. It covers 2010-2020 and divides the Affordable Care Act’s provisions into 14 different categories, including children’s health. Users can select federal and/or state developments and click on entries for more information.
Iowa Paper Calls on Congress to Extend FMAP—This Des Moines Register editorial urges Congress to extend the increased FMAP authorized by last year’s economic stimulus law. The editorial rightly observes that it’s politics that has changed since Congress last prioritized FMAP, not the tough times facing state budgets or the even tougher times facing families struggling through the recession. The only things missing from this very strong editorial are a reference to the uptick in Medicaid enrollment since the recession began and an effort to localize the issue for specific lawmakers, but all-in-all a great example for advocates who may be planning editorial board outreach.
Oregon Pediatricians Applaud Health Reform—This op-ed in the Oregonian, authored by leading pediatricians, describes the many benefits of health care reform for kids. It highlights popular insurance market reforms, but also applauds the wellness benefits that children will get from the medical home model of care, the array of important free preventative services that children will now be able to access as they grow up and the additional supply of pediatric specialists who will join the workforce as a result of the bill. The authors are powerful spokespersons for children’s health, and their ability to present in-depth knowledge in a personally-relevant way makes for a compelling op-ed. Pediatricians in Michigan placed a similar op-ed that we shared two weeks ago. To add the voices of your own state’s pediatricians on this key message, consider connecting with local AAP leadership on the possibility of a shared op-ed.
July 14, 2010
This week, the Finish Line Flash includes a great op-ed from Korey Capozza of Voices for Utah Children as well as a handy brief on health reform’s impact on children and a new study that points to nationwide improvement in retaining kids in coverage.
Help is on the way for families with sick (or recovering) kids–This op-ed in the Salt Lake Tribune from Finish Liner Korey Cappoza, of Voices for Utah’s Children, applauds new health reform provisions requiring insurers to cover children with pre-existing health conditions. Korey uses well-told anecdotes to expose a flaw in the current system — many Utah families whose children are denied private coverage for minor or resolved health conditions then face unaffordable costs in the state’s high risk pool. The op-ed shows how health reform families get and keep the private coverage they need – an important message to send as the implementation debate unfolds.
Health Reform Resources
Urban Brief Explains Health Reform’s Impact on Children—The Urban Institute and the Robert Wood Johnson Foundation released a quick 2-pager that highlights the effects that the Affordable Care Act will have on children. The brief is one in a series of publications that look at how the new law will affect different populations.
Health Affairs Study Suggests Improvements in Retention—Benjamin Sommers updated a previous study on eligible but unenrolled children and found that retention improved from 2006-2008. He found a reduction in the proportion of uninsured children who were enrolled in Medicaid or CHIP the previous year. Nonetheless, about 36% of uninsured children had previously been enrolled in public coverage.
July 7, 2010
The Finish Line Flash this week updates you on two new guidance letters from CMS, shares two media pieces on health reform, and links you to a guide to state health reform implementation from U.S. PIRG.
Immigrant Coverage—Last week, CMS issued a state health official letter to provide guidance on CHIPRA’s state option to cover lawfully residing immigrant children and pregnant women present less than five years. The guidance clarifies that “lawfully residing” means individuals who are legally present in the U.S. (based on Department of Homeland Security regulations) and who meet the state’s residency requirement. It further requires that states that elect this option do so for all eligible lawfully residing individuals. For instance, a state could not restrict eligibility to only the “qualified aliens” identified in the welfare reform law. States may initially claim the CHIP match rate for individuals at any income level covered under this provision. However, once the individual has been present for five years (and thus eligible without the option), the Medicaid match rate will apply to those with income that makes them Medicaid eligible.
Translation and Interpretation Services Administrative Match Rate—CMS also released a state health official letter on the increased federal match available under CHIPRA for translation and interpretation services. The increased match rate is 75% for Medicaid and for CHIP is the higher of 75% or the state’s CHIP rate plus 5 percentage points. States may claim this increased match for expenses incurred after February 4, 2009. The increased match applies only to administrative expenses, not expenditures on benefits. The letter provides examples of allowable expenses.
A Look at Health Reform’s Early Benefits—This AP story offers a welcome focus on the early benefits of health reform for children and families. The article has a positive tone and uses a compelling personal story to illustrate reform’s value, while maintaining the balanced approach appropriate for a news story. Note, in particular, how well the quote from the Commonwealth Fund spokesperson dovetails with the parent’s quote.
Michigan Physicians Endorse Health Reform—Written by a pair of Michigan doctors, this op-ed showcases health reform’s early wins for children and families. It features not only immediate coverage improvements for kids, but also forecasts access gains and quality improvements from reform. This great example also illustrates how advocates can put critiques (here, the cost to states) in the most strategic context, starting and ending with a focus on the value of reform to kids and families.
Health Reform Resources
State Guide on Health Reform from U.S. PIRG—The advocacy organization recently published a guide for state health reform implementation decisions. It discusses how states can work to make sure health reform is as beneficial as possible for consumers. The guide considers exchanges, efforts to lower costs and improve quality, consumer protections, and potential ways for states to go beyond the federal reforms.
June 30, 2010
This week, the Finish Line Flash passes along some messaging tips to help with state responses to Congress’s failure to extend increased Medicaid funding. We also point you to a useful Urban Institute brief on the impact of health reform on states and a study that examines ways to improve treatment under EPSDT.
Message Set on FMAP Extension Stall—As you know, last week the U.S. Senate failed to advance a bill to extend increased FMAP payments beyond December 2010. Since many states counted on this funding in their approved 2011 budgets, state policymakers may look to make cuts to make up for the unrealized federal Medicaid funding. CCF and Spitfire Strategies have developed a message set to help you respond to such proposals. Since the maintenance-of-effort requirement in health reform will protect eligibility standards and procedures, proposed cuts may focus on provider payments or other areas. Your Finish Line and Narrative teams are available to help you tailor these messages to your state and would also like to hear of any state reactions to this stall in the FMAP extension.
Health Reform Resources
Urban Brief on PPACA’s State Impact—Following up on the recent estimates of state Medicaid spending for adults under health reform, the Urban Institute released a brief (3 pages) that describes the broader range of impacts health reform will have on states and their finances. The report cites reduced uncompensated care costs as well as changes to spending on currently covered adults, children, and elderly and disabled populations. It puts into writing the estimate that states could save approximately $70-80 billion over the 2014-2019 period through reduced uncompensated care costs and finds that “states as a whole can probably achieve savings that significantly exceed their increased costs for low-income Medicaid adults.”
NASHP Examines EPSDT Treatment—A new National Academy for State Health Policy brief explores states’ efforts and opportunities to improve access to treatment services in EPSDT. It looks at why some children do not receive covered benefits and identifies strategies some states use to improve appropriate use of EPSDT.
June 16, 2010
This week, the Finish Line Flash brings you news and resources on the newly-released federal regulations on “grandfathered” health plans as well as on the announcement of the first funds available under health reform’s maternal and child home visitation grants.
Health Reform Resources
New Rules Define Grandfathered Plans—Three federal agencies (HHS, Labor, and Treasury) this week released regulations to define which health plans will qualify as grandfathered plans under health reform. Grandfathered plans are those in existence on March 23, 2010 that will be exempt from some—but not all—of the new insurance regulations contained in health reform. Grandfathered plans can retain their status by limiting changes to benefits and cost-sharing; changes over specified limits will trigger the consumer protections that apply to new plans. HHS has produced a fact sheet and question-and-answer document explaining the regulations. CCF has developed brief talking points to address the new rules and added them to the collection of messaging recommendations on health reform on the Finish Line website.
First Funds for Home Visitation—PPACA devotes $1.5 billion through 2014 for maternal, infant, and early childhood home visitation programs. They are intended to help build quality, comprehensive statewide early childhood systems for pregnant women, parents and caregivers, and children from birth to 8 years of age – and, ultimately, to improve health and development outcomes. The first funding opportunity under this grant has been announced by the Health Resources and Services Administration. These funds will help states complete a needs assessment which qualifies them for both existing Title V funding and the new PPACA grants. Applications are due by July 9, 2010.
June 10, 2010
The Finish Line Flash this week quickly shares an update on the extension of increased FMAP for states and a news item that clearly highlights one of the early wins for kids from health reform.
Debate Continues on FMAP Extension—As you know, an extension of the increased FMAP for six months through June 2011 has been pending in Congress for many months. In the past, both houses have passed extensions in different legislation, but have not yet agreed on a consolidated bill. At the end of May, the House removed the extension from legislation it passed. Senators, though, have already acted to restore the extension to the same bill as it moves through the Senate. Votes by the full Senate and the full House will still be required to put the FMAP extension into law. Senate Majority Leader Reid has pledged to move forward on such a vote before the Senate’s July 4 recess, but House timing remains uncertain.
Early Win Recognized by Illinois Paper—Highlighting the end in insurance denials because of pre-existing conditions, this article puts an early health reform win for kids front and center, and demonstrates some of the current and future changes that will affect coverage for kids and families. A great model for other states – this piece shows how advocates can use family stories to illustrate the reality of health reform’s benefits. Your Finish Line or Narrative team can help you put together a similar illustration of these benefits using a family story from your state–just give us a call.
June 2, 2010
This week, the Finish Line Flash brings you two new briefs that provide guidance on the state implementation of health reform, coverage of a report on the economic impact of state budget choices, and a new report confirming that too few children receive the EPSDT benefits for which they are eligible.
Health Reform Resources
NASHP Briefing Identifies State Priorities—The National Academy for State Health Policy recently released a brief that describes 10 key priorities for states as they implement health reform. The briefing is a high-level overview of the areas that will require the most attention from state policymakers. The briefing is an early product from the State Consortium on Health Care Reform Implementation—a collaboration among NASHP, the National Governors Association, the National Association of Insurance Commissioners, and the National Association of State Medicaid Directors.
List of State and Community Responsibilities and Options—A partnership between the University of Michigan and Blue Cross Blue Shield of Michigan, the Center for Healthcare Research and Transformation, has produced a brief that lists many of the state requirements and options under health reform. The document provides a brief bullet point for each requirement, demonstration grant, or program option, organized by year. Note that the brief includes many grants and options that were in included in the reform law but for which funding has not yet been appropriated.
California Study Measures Impact of Cuts to Health Services—This article and corresponding report from the University of California – Berkley’s Center for Labor Research and Education tracks nicely with the “balanced approach” messaging we have been focusing on lately. The data makes the point that cutting health services can be harmful to the economy, even while policymakers claim to be rescuing the budget.
HHS OIG Finds Most Kids Don’t Get the Right Screenings—As most of us know, Medicaid’s EPSDT benefits fail to reach many of the children who are eligible for them. The HHS Office of the Inspector General has helped to quantify the extent of the problem. The OIG sampled Medicaid cases from 9 states from 2007 and reviewed medical records. It found that 76% of children did not receive 1 or more of the required medical, vision, or hearing screenings and 41% of children did not receive any required medical screenings. Of those who did receive medical screenings, nearly 60% lacked at least one component of a complete medical screening. The report also includes a brief discussion of state efforts to improve screening rates.
May 26, 2010
The Finish Line Flash this week shares some numbers we’ve been eagerly awaiting—state-by-state estimates of Medicaid enrollment and spending under health reform from the Urban Institute and the Kaiser Commission on Medicaid and the Uninsured. We’ve included some updated talking points to address these numbers. Also this week, we link you to three effective media pieces—one each from Arkansas, Texas, and California.
Health Reform Resources
State-by-state Medicaid Analysis Released—The Kaiser Commission on Medicaid and the Uninsured today released an analysis, performed by the Urban Institute, that estimates adult Medicaid coverage for 2014-2019 and the federal and state spending for that coverage. The analysis developed estimates under two scenarios—one which mirrors the Congressional Budget Office’s cost estimates and assumes Medicaid participation rates similar to current levels and another that assumes more robust participation due to the individual mandate and increased federal and state outreach efforts. Note that the estimates are limited to Medicaid spending for adults and do not include savings that states will realize due to the reduction in the number of the uninsured, such as reduced spending on uncompensated care. CCF developed talking points on the report for your use.
Arkansas Finish Liners Win Coverage for Report—Arkansas Advocates for Children and Families this week published a report highlighting the number of eligible but unenrolled children in the state. In addition to radio and TV coverage, the Arkansas New Bureau covered the release and picked up on important elements of kids coverage messaging.
Texas Story Shows Value of Dependable Coverage—This powerful story from Texas underscores the important role insurance coverage plays in the day to day lives of kids and families. From sports to field trips to learning to drive, kids need comprehensive coverage that guards against injury, whether it’s as severe as Shelby Sherman’s paralysis or just bumps and bruises. Fortunately, this story has a happy ending for both Shelby’s health and his family. Now, with coverage through CHIP, Shelby’s mother has peace of mind when her son goes out on the football field.
California Legislator Calls for Balanced Approach—California Assembly Member Bill Monning’s op-ed is a great example of the “balanced approach” budget messaging recommendation at work. He starts in exactly the right place – asserting that the state’s budget should reflect what California values most. He then paints a clear picture of the harm that will result if the state relies on cuts alone – using human terms and local references. Then he shows why cuts alone are not smart policymaking – in this case pointing to the likelihood that the state will lose federal funding. Then he offers a concrete alternative that puts revenue on the table. It’s not perfect – he could have done more to make the value of revenue options as clear and compelling as the costs of cuts alone, and the piece would have been more effective if he’d been more committal on the revenue option. But it’s a really strong example for partners interested in putting this messaging recommendation to work.
May 19, 2010
This week, a quick Finish Line Flash announces CCF’s new role with the National Covering Kids and Families Network, links you to two helpful resources on health reform, and shares a strong editorial from California.
CCF to Serve as Policy and Technical Resource Center—Many Finish Liners and Narrative grantees are part of the National Covering Kids & Families Network, and the rest are likely familiar with the network. CCF is happy to announce that it will take on the role of the policy and technical resource center for the network. Starting this month, CCF will help the coalitions continue to build their capacity and broaden their policy expertise. We’ll also promote best and promising practices and provide network members with opportunities for peer-to-peer learning.
Health Reform Resources
Consumer Advocates Analyze Insurance Market Reforms—In addition to its Medicaid and CHIP provisions, health reform will impact many families through the changes it makes to private insurance markets. The consumer representatives to the National Association of Insurance Commissions recently released a paper that both details these changes and makes recommendations aimed at ensuring that the reforms benefit consumers as strongly as intended. The paper is a great resource for understanding provisions of the law that will be important for children and families, but may not have been tracked closely by those of us who focus on public programs. It also provides guidance on key implementation decision points.
Medicaid Directors Contemplate the Future of the Program—The Kaiser Commission on Medicaid and the Uninsured recently released a brief on opportunities for improving Medicaid under health reform. Based on interviews with Medicaid directors and other experts, it considers ways to strengthen enrollment and renewal to meet increased eligibility as well as whether the program should be re-branded in light of health reform.
California Newspaper Connects State, Federal Health Care Efforts—This editorial from California takes Gov. Schwarzenegger to task for his wavering support for health reform and his recent statements about cutting the Healthy Families program. This piece uses strong arguments about cost-effectiveness, especially when it comes to federal funding, and the potential side effects, including job loss, that could occur in California should Gov. Schwarzenegger take drastic action. Finally, the editorial calls on the governor to show renewed leadership and present a budget that shows that California values the health and well-being of its children and families.
May 12, 2010
The Finish Line Flash this week points you to effective commentary from Utah and Kansas, brings news of the new HHS regulations on dependent coverage for adult children, points out a useful clearinghouse on health reform implementation, and reminds you of a grant opportunity from the Robert Wood Johnson Foundation.
Reform’s Impact on One Utah Family—In this op-ed, the author uses his own family’s particular health care needs to show all the ways that health reform delivers what American families need. The authenticity shines through not only because the author writes from a very personal perspective, but also because he spells it out in ways that are both approachable and familiar to many Americans. This simple but creative idea is a great example of the messaging strategy recommended at the regional meetings, which focuses the conversation on the wins health reform delivers for kids and families, and it’s a great model that can be emulated in every state.
Kansas Governor Pushes Back at Chamber, Wins Praise–This great editorial from the Kansas City Star really delivers on the messaging recommendations we made during the regional meetings, especially moving the focus away from the budget as an end in itself and refocusing on the budget as a means to deliver on what’s important to the state. Kansas Gov. Parkinson’s statement, which the editorial prints in its entirety, clearly communicates budget priorities in human terms and positions the state’s chamber of commerce as a mean-spirited schoolyard bully. And the Star delivers an endorsement of the governor’s decision to take on the anti-tax, anti-government culture cultivated by the chamber and notes that local chambers have broken ranks to support smart revenue measures. This is a great model for any courageous state or local official who wants to start changing the conversation.
Health Reform Resources
Dependent Coverage Regulations Released—One of health reform’s early wins is the requirement that private health plans that offer dependent coverage allow that coverage for adult children up to age 26. This week, HHS, along with the Departments of the Treasury and Labor, released the regulation clarifying how this requirement will work. The rule “applies to all plans in the individual market and to new employer plans. It also applies to existing employer plans unless the adult child has another offer of employer-based coverage.” A fact sheet and FAQ are also available from HHS.
Health Reform GPS—The George Washington University School of Public Health and Health Services and the Robert Wood Johnson Foundation have collaborated to produce a very useful clearinghouse of information on health reform implementation. The website tracks new developments and archives important documents, such as a consolidated version of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.
Getting Americans Covered Grant—The Robert Wood Johnson Foundation is currently accepting brief proposals for grants focused on implementing health reform. The Foundation seeks projects that address specific aspects of the new law that present significant opportunities to expand coverage. The projects can cover a range of activities from coalition building to strategic communications to policy evaluation and analysis. While there is a preference for projects with a national reach, state-focused projects will also be considered if they can demonstrate benefits for other states. The deadline for initial proposals is May 27.
May 5, 2010
This week’s Finish Line Flash shares a great video produced by California’s 100% Campaign and passes along several useful new publications on health reform from Families USA, the Commonwealth Fund, and Health Affairs together with the Robert Wood Johnson Foundation.
California Advocates’ Video Features Families—A new video from the 100% Campaign shares the stories of several California families who benefit from Medicaid and CHIP. The video demonstrates a great way to combine some simple statistics on the importance of coverage with compelling testimony from the real people the numbers describe.
Health Reform Resources
A Checklist for State Advocates from Families USA—Health reform clearly has far reaching impacts on our work and we’re all working hard to evaluate and understand them—even as decision points already approach. To help with the first few months of implementation, Families USA has released a helpful document to guide state advocates through some of the early tasks that can help make sure implementation is as effective as possible. Arranged as a to-do list, the guide covers topics from high-risk pools to consumer assistance to early expansions and more.
More Explanation of Reform: Commonwealth and Health Affairs/RWJ—Explaining the many different aspects of the reform law to diverse audiences will take a wide range of materials. Different messengers, points of focus, and levels of detail will be required to make the right point to the right person. Two new publications surfaced this week that would be useful to have at your disposal. The Commonwealth Fund released a 12-page, plain English explanation of reform intended for journalists but useful for others, as well. Health Affairs, in conjunction with the Robert Wood Johnson Foundation, developed a short paper on the near-term changes under reform, helping to reinforce the points made in CCF’s Early Wins issue brief.
April 29, 2010
The Finish Line Flash this week brings news of a Responsible Budget Coalition rally in Illinois and colorful testimony on health reform in Nevada. It also offers you links to a handy poster from PICO that helps families understand health reform and a report from UnitedHealth that includes state estimates of Medicaid enrollment and costs under reform.
Illinois Rally Showcases a Balanced Approach—This recent news article from Springfield, IL shows the “Balanced Approach” budget messaging in action. John Bouman of the Sargent Shriver Center on Poverty Law is leading the charge at the statehouse in support of Gov. Quinn’s proposed 1% tax increase. This article urges policymakers to the do the right thing in supporting the funding increase and provides an antidote to some of the anti-tax rhetoric that has been cropping up in state capitals and statehouses across the U.S. Kudos to John and the Shriver team for leading the way on revenue!
Nevada Advocate Echoes VP—As families, providers, and state officials work to understand how health reform will affect them, it’s important for advocates to carry the message that reform will not only bring coverage to millions, it will also bring enormous federal investments into each state’s health care system and economy as a whole. Nevada Legal Service advocacy director Jon Sasser did a great job making this point to state lawmakers, calling health reform not only a “big freaking deal”, but a “great freaking deal for Nevada.”
Health Reform Resources
Poster Explains Reform and Can Be Yours—The PICO National Network has produced a poster that explains how major provisions of the health reform law affect families based on how they currently get health coverage. The poster is available for download or a printed version can be ordered from PICO.
Insurance Report Studies Medicaid Costs and Potential Program Changes–UnitedHealth is one of America’s largest health insurers as well as one of the largest Medicaid health plans. The company’s Center for Health Reform & Modernization recently released a working paper that examines costs and potential savings to states under health reform and through a range of Medicaid program changes that it proposes. The document is useful on a couple of fronts: It presents state-by-state estimates of Medicaid costs and enrollment as a result of health reform over the six-year period 2014-2019. It also sheds light on the kinds of policies that the managed care industry is pushing with state legislators looking for savings in their Medicaid budgets — in particular around expanding Medicaid managed care, long-term care, and the administration of public programs.
April 16, 2010
This week’s Finish Line Flash shares some good news from Colorado and links you to some useful resources on health reform—a media piece that explains the impacts of the bill, a small business tax credit calculator, and an updated messaging memo.
CMS Approves Colorado Hospital Fee—CMS recently approved Colorado’s use of a hospital provider fee to fund the state’s expansion of Medicaid and CHIP. The fee is expected to raise $600 million per year which will be eligible for federal match. This will allow the state to cover 100,000 additional individuals and raise CHIP eligibility to 250% of FPL, effective May 1.
Health Reform Resources
The Fiscal Times Explores Reform’s Effect on Individuals—Journalists at The Fiscal Times examined how the health reform legislation would impact the health care spending of average Americans in six brief case studies. Looking at families and singles, high and low earners, older and young adults (though not specifically children), the article explains how certain provisions of the new law will affect the individuals and families selected.
Small Business Majority Allows Businesses to Calculate Tax Benefits—In addition to the Early Wins for Children and Families in Health Care Reform, another near-term benefit from the new law is the tax credit for small businesses. Starting this year, the law allows small businesses to claim a credit against their taxes for a portion of their contributions to employees’ health insurance premiums. Using a calculator hosted by Small Business Majority, small businesses can estimate the value of this credit.
Messaging Memo Updated—We’ve alerted you before to the messaging resources on health reform that are available above. The Messaging Recommendations Memo has now been updated to better respond to the developing conversation around the provisions on preexisting condition exclusions for children. Most of the recommendations remain unchanged, but we welcome your feedback and field reports on how the new law is being discussed in your state and how the messaging works.
April 2, 2010
The Finish Line Flash this week sends you a memo that brings together our messaging recommendations around health reform and shares an example of them in use. We also link you to a useful website from Illinois that helps in planning an enrollment event and a state-by-state breakdown of federal funding under health reform and stimulus legislation.
Health Reform Messaging
Memo Pulls Together Draft Recommendations—Spitfire Strategies has compiled a memo with the draft messaging recommendations around health reform, background information, and a request for feedback. The memo will be shared with attendees at the final two CCF regional meetings. But we want to make sure you have access to it as soon as possible. You can find the memo, along with other talking points and sample materials, above. Some Finish Liners have already put these messages to use. Voices for Utah Children, for example, placed a letter-to-the-editor in the Salt Lake Tribune.
Outreach and Enrollment
New Website Provides a Guide to Planning an Enrollment Event—The Sargent Shriver National Center on Poverty Law in Illinois has developed a handy website to aid in the planning of an event to enroll kids in coverage. While the site is still under review and has not yet been shared with community partners, it can already serve as a model for other states. From getting started, to recruiting partners and volunteers, to winning publicity, the toolkit walks through the steps leading to a successful event. Such events can not only boost enrollment in coverage, but also serve to generate interest and enthusiasm among key stakeholders in kids coverage.
HCAN Shows Federal Payments to States and Individuals—Health Care for America Now calculated the federal funds that will go to governments and individuals in each state over the next ten years under health reform, ARRA, and the not-yet-approved jobs bill. While other groups are likely to release similar estimates, these are the first we’ve seen. For each state, the analysis shows the increased federal funding for each year in both Medicaid spending and subsidies to individuals for private health insurance.
March 26, 2010
This week, the Finish Line Flash adds to our growing collection of messaging assistance on health reform, shares a strong opinion piece from Arizona, and links you to Ohio Governor Strickland’s statement on accepting the challenge to cover all eligible children.
Health Reform Messaging
Sample Press Release and Letter to the Editor—As mentioned in yesterday’s e-mail, the Finish Line section of the CCF website now carries suggested message points on the passage of health reform and its impacts on states–see above. CCF and Spitfire Strategies have now added a sample press release and letter to the editor that can be adapted for use in your state. Please feel free to contact your Narrative or Finish Line team members for further assistance in responding to this week’s exciting action on reform.
Arizona Paper Calls for Restoration of KidsCare—This editorial from Arizona takes Gov. Brewer and state legislators to task for their recent decision to cut KidsCare, the state’s version of the Children’s Health Insurance Program. The Editorial Board urges Gov. Brewer not to jeopardize the state’s fiscal situation as well as the health of kids on KidsCare. The editorial makes specific, targeted statements at lawmakers and their values and makes the case that restoring KidsCare should be a top priority
Governor’s Statement on the Enrollment Challenge—This statement from Ohio Governor Ted Strickland (D) announces that Ohio will accept Sec. Sebelius’ challenge to enroll Ohio’s eligible but uninsured children. Gov. Strickland talks about the importance of children’s coverage for both kids and their families and makes a commitment to removing red tape roadblocks through simplification measures. Gov. Strickland’s announcement is a big win for Ohio’s children and their families and hopefully other states will step up and accept the challenge as well. Read Tricia Brooks’ post on the Ohio decision and the Secretary’s Challenge: Connecting Kids to Coverage on the CCF blog
February 26, 2010
This week, the Finish Line Flash passes along news of two important announcements from CMS: All states will receive increased stimulus funds through changes to the “clawback” formula and many states have been awarded grants under CHIPRA’s quality improvement provisions.
To access the Finish Line section of CCF’s website, use the username childhealth and the password finishline.
ARRA FMAP Applies to “Clawback” Formula- Under the Medicare Part D prescription drug benefit, states must make payments to the federal government to offset prescription drug costs; these payments are often referred to as “clawback” payments. States’ payments are based on their share of Medicaid costs. Because of ARRA’s increase to federal matching rates, states pay a smaller share of Medicaid costs than they otherwise would. HHS recently announced that it would apply the reduced state share to the clawback formula, retroactive to ARRA’s effective date of October 1, 2008. This will result in multi-million dollar reductions in states’ payments – see a state-by-state breakdown at the link above. The announcement is a great opportunity to remind policymakers that Congress boosted FMAP rates to protect state Medicaid programs and these newly identified state savings should go to maintain Medicaid budgets.
CHIPRA Quality Grants Announced – CHIPRA provided $100 million over five years for grants to states to improve the quality of care for children in Medicaid and CHIP. HHS announced the grants this week, awarding 18 states with funds either individually or as part of multi-state collaboratives. The money will help states implement and evaluate provider performance measures and utilize health information technologies such as pediatric electronic health records and other quality improvement initiatives. The list of states and grant amounts is available at the link above.
As always, please feel free to contact any of us,or any of your fellow grantees using the listserve, with any questions you have.
February 19, 2010
The Finish Line Flash this week links you to new resources on the importance to states of enhanced Medicaid funding, shares what we know so far on next week’s White House Health Care Summit, passes along a strong op-ed from California, and reminds you of new CMS leadership.
New Resources on FMAP—Two new publications highlight the importance to states of the enhanced Medicaid funding that was included in ARRA and is set to expire at the end of December 2010. Families USA released a report that includes state-specific data from the President’s budget and the National Association of State Medicaid Directorsshared responses from a survey of states on how they would respond if the funding expires.
White House Health Care Summit on Thursday—As has been widely reported, President Obama is planning to hold a summit on health reform on Thursday, Feb. 25. We expect the White House to release a revised health reform proposal in advance of the meeting, so for the latest, keep an eye on the White House Office of Health Reform website at http://www.healthreform.gov/.
California Advocates Call Out Schwarzenegger—This excellent op-ed comes from Wendy Lazarus at The Children’s Partnership. The messaging here is clear: it’s time to hold Gov. Schwarzenegger accountable when it comes to his public statements about children’s health care coverage. This op-ed was placed in a statehouse-focused newspaper as budget negotiations begin. It effectively uses messages about cost-effectiveness and budget priorities that match the state’s values to create a message that will surely ring in policymakers’ heads as they debate the various children’s coverage proposals.
CMS Family & Children’s Health Programs Group Director—As you know, Cindy Mann joined CMS in mid-2009 as Director of the Center for Medicaid and State Operations (CMSO). Cindy has since been joined by Vikki Wachino. Vikki serves as Director of the Family & Children’s Health Programs Group, the group within CMSO that oversees the child and family portions of Medicaid as well as CHIP. Last fall, Joan Alker noted the appointments of Vikki and Barbara Coulter Edwards on the Say Ahhh! blog.
February 5, 2010
In addition to the CHIPRA Anniversary materials we shared yesterday, this week’s Finish Line Flash provides a quick update. We remind you of Monday’s call on revenue measures, link you to the CHIPRA guidance CMS has recently released, and fill you in on the latest federal matching rates. Starting next week, look for the Finish Line Flash to land in your inbox earlier in the week.
Revenue Call on Monday—A call with Finish Line, Narrative, and CHIPRA Implementation grantees will take place on Monday, February 8, 4:00 – 5:00 pm Eastern. Speakers will include Nick Johnson of the State Fiscal Analysis Initiative, Regan Gray of Children First for Oregon, Jon Gould of the Children’s Alliance in Washington, and others who wish to share their efforts to address state revenues. Please dial 866-910-4857, 609561#.
New Guidance from CMS— This week, CMS released new guidance on the provisions of CHIPRA related to Express Lane Eligibility, Premium Assistance, and Prospective Payment for FQHCs and RHCs. All are available on the CCF website.
FMAPs Updated—As you know, the provisions of the American Recovery and Reinvestment Act (ARRA) affect state’s Medicaid matching rates. FMAPs for the first quarter of 2010 are now available. Most states’ FMAP remains the same as in the final quarter of 2009, but some have seen increases, most notably Iowa, which saw an increase of nearly 2 percentage points.
January 29, 2010
This week the Finish Line Flash passes along new messaging suggestions from CCF and Spitfire, notes two new guidance letters from CMS, and links you to an effective op-ed placed by the Colorado Finish Liners.To access the Finish Line section of CCF’s website, use the username childhealth and the password finishline.
Mark Your Calendars
Call in the Works—Please hold Monday, February 8, 4:00 – 5:00 pm Eastern, for a conference call for Finish Line and Narrative grantees. Details will follow on the topic and speakers.
CHIPRA Anniversary Messages—Next Thursday, February 4, will mark the first anniversary of the signing of CHIPRA. It’s a great opportunity to speak out on the success your state has had in covering children and families through CHIP and Medicaid. And with health reform at a crucial moment, now is an important time for policymakers and the public to be reminded of the success of public programs in providing health security to Americans. CCF and Spitfire have developed a set of suggested messages that you can adapt for your own state–please feel free to use all or any portion of the messaging. And as always, you can call on your Finish Line or Narrative team members for further assistance in putting them to use.
CHIP Premium Grace Periods—CMS recently released a State Health Official Letter that provides guidance on CHIPRA’s requirement of a 30-day grace period for the payment of CHIP premiums. The letter contains info on when the grace period begins and the notice that must be provided to families.
Protections for Indians in Medicaid and CHIP—CMS also released guidance on the new protections for Indians enacted as part of the Recovery Act (ARRA). ARRA provides certain premium and cost-sharing protections under Medicaid and exemption for certain Indian-specific property from consideration in determining Medicaid eligibility and from Medicaid estate recovery. It also provides certain Medicaid managed care protections for Indian health programs and Indian beneficiaries and establishes new requirements for states to consult with Indian health programs on Medicaid and CHIP.
Colorado Finish Liners Place Op-Ed—Making a strong case for getting to the finish line and covering all kids, Colorado’s Finish Line team marshaled a range of statistics to urge quick action in a guest column in the Colorado Statesman. The column recognizes the success to date and makes it clear that the goal of coverage for all kids is within reach.
January 22, 2010
The Finish Line Flash this week passes along a new resource from CCF–Five Reasons Not to Add Red Tape to Your Child and Family Health Programs–and shares Washington’s Governor Chris Gregoire’s defense of health coverage for kids and families in her State of the State address and budget proposal.
Avoiding Red Tape before It Sticks—CCF recently released a very brief summary of five reasons why adding barriers to enrollment can be counterproductive for states. The summary comes in two flavors–one page and two pages (plus notes), for easy use in communications with policymakers. It encapsulates the data-supported case for keeping health coverage accessible even as states must cut their budgets. It’s made for your use, so feel free to use it as-is or incorporate it into your own materials. For a great example of a Finish Line document on cutting red tape, see this brief from the folks in Ohio.
Washington Governor Speaks Out for Coverage—Washington Governor Chris Gregoire came out strongly in favor of protecting health coverage for kids and families in her State of the State address. Referring to the legislature’s budget, she said “The balanced budget takes away health care for 70,000 individuals and 16,000 children. That’s not fair. We must not deny health care to families and kids and then pass the costs on to the insured.” She proposed to maintain full funding for Apple Health, including reinvesting all of the state’s CHIPRA performance bonus funds back into the program.
January 15, 2010
A quick Finish Line Flash this week shares an effective legislative leave-behind from Rhode Island and a report for the Urban Institute on improving the enrollment provisions in health reform.
Rhode Island Shows Kids Coverage Results—The Rhode Island Finish Liners produced a handy memo and visually-appealing policy brief and distributed them to legislators at the opening of the state’s session. The brief demonstrates the value of kids coverage by using data to show improved outcomes over time. The package is a great example of taking time to establish a positive message around kids coverage heading into another tough budget environment.
Finding the Best Eligibility and Enrollment Provisions in the Health Reform Bills—While other topics have captured the headlines, many of us recognize that nuts and bolts enrollment procedures will have an important effect on the success of health reform. The Urban Institute this week released an analysis of the eligibility, enrollment, and retention provisions in the health reform bills passed by the House and Senate. The report identifies the most promising provisions in each bill and make recommendations for reconciling the two proposals.
January 8, 2010
This week the Finish Line Flash points out three documents—two with opportunities to comment—that federal agencies released at the end of the year in response to requirements in CHIPRA. We also share a new study that ranks the states on the out-of-pocket expenses faced by low-income families who care for children with special health care needs (CSHCN).
Citizenship Documentation Guidance Released—CMS published a State Health Official letter on December 28 with further details on the sections of CHIPRA related to citizenship documentation. As expected, the agency confirms that states must give applicants a reasonable opportunity to provide documentation of their citizenship and may not delay, deny, reduce or terminate Medicaid or CHIP eligibility during this opportunity. The letter also provides more information on documenting citizenship through a data match with the Social Security Administration.
Comments Requested on Initial Core Quality Measures—As required by CHIPRA, the Agency for Healthcare Research and Quality published for comment its initial core set of quality measures. On a voluntary basis, states may use these measures to fulfill the quality reporting requirements in their Medicaid and CHIP programs. While the set includes a range of clinical measures, the agency acknowledged that it could not identify an available, valid, and feasible measure of the duration of enrollment and coverage or enough measure of the availability of services. Comments are due by March 1, 2010.
Comments Requested on Interstate Medicaid and CHIP Compatibility—Yet another section of CHIPRA requires CMS to develop a model for the coordination of the enrollment, retention, and coverage under CHIP and Medicaid of children who frequently change their state of residence. The agency is requesting comments on five models for coordination, any best practices that exist currently, or new models for coordination. Comments are due by January 19 and more information is available from Regulations.gov.
Study Examines Effects of State Choices on Families with CSHCN—In the latest Pediatrics, researchers used data from the National Survey of Children With Special Health Care Needs to study the financial burden faced by low-income families with CSHCN in different states. They found that families living in states with higher Medicaid and CHIP income-eligibility guidelines were less likely to have high financial burdens. The full article includes a ranking of states by how many families pay more than 3% of income in out-of-pocket costs.