By Jordan Rau and Julie Appleby
Kaiser Health News
June 28, 2012
The individual mandate - the most controversial provision of the Affordable Care Act (ACA), which many observers thought was likely to have a domino effect and topple the whole national health reform law if it were struck down - ended up being the "leg" the ACA will stand on. In his majority opinion, Chief Justice John Roberts Jr. wrote that the "penalty" for not having insurance is a tax, and so the individual mandate is constitutional under Congress's taxation authority.

One of the main goals of the ACA is to make health insurance available and affordable to the majority of Americans. However, the Court ruled that a provision that would have advanced that goal for 30 million Americans by creating a pathway to Medicaid coverage for childless adults with very low income was found to be coercive. Rather than make the Medicaid expansion a requirement of the law, the Court ruled states have the option to expand Medicaid, but if they do not, they will not be penalized with the loss of all matching federal funds for their Medicaid programs. With the constitutionality of the ACA decided, states will have to move quickly to develop and set up the state health exchanges that must be ready to open in January 2014. States must also work to improve their computer systems and link them with federal agencies to streamline eligibility determinations for Medicaid or tax credits through the exchanges.

By Sara Collins and Karen Davis
The Commonwealth Fund Blog
June 28, 2012
On June 28, 2012, the U.S. Supreme Court ruled that the Affordable Care Act (ACA) is constitutional. In response to the Court's decision, this blog post by Sara Collins and Karen Davis of the Commonwealth Fund provides examples of how provisions of the ACA that are already in effect have "...begun to transform both insurance markets and the nation's health care delivery system." These include extending health insurance coverage to young adults on their parents' health plans, banning lifetime dollar amounts for coverage, and the removal of cost sharing for preventive services. In addition, insurers that failed last year to meet the ACA's requirement to limit the amount of money they spent on administrative fees and maximize the amount paid for medical costs will have to provide rebates to individuals and small businesses. These rebates will total more than $1 billion dollars, and consumers will start seeing checks this summer.

By Janice D'Arcy
On Parenting, a Washington Post Blog
June 28, 2012
In this blog post, Janice D'Arcy, a Washington Post reporter, notes that child advocacy groups breathed a collective sigh of relief upon learning that the U.S. Supreme Court upheld the individual mandate provision of the Affordable Care Act (ACA) and subsequently ruled the health reform law is constitutional. The only exception is the provision to expand Medicaid eligibility to individuals with income up to 133% of the federal poverty level. This can be done as a state option, but is no longer a requirement of the law. D'Arcy writes that the Court's finding ensures that the conditions of the ACA that provide access to coverage for children remain in place. With the exception of grandfathered individual health plans, the ACA prohibits insurers from denying or limiting coverage for children with pre-existing conditions. And children whose families make too much money to qualify for Medicaid and who do not have access to affordable employer-sponsored insurance will still be able to access coverage through the Children's Health Insurance Program (CHIP), which remains funded through 2015.

By Erica Ryan and Matt Stiles
National Public Radio
June 28, 2012
This interactive tool includes the full text of the U.S. Supreme Court's written decision about the Affordable Care Act (ACA). The formal title is National Federation of Independent Businesses ET AL. v. Sebelius, Secretary of Health and Human Services, ET AL. Read the entire document, navigate to a specific page, and use the "NOTES" tab to view commentators' notes about specific sections of each judge's opinion.

By Lisa Shapiro
First Focus: Making Children and Families the Priority
June 2012
In this fact sheet, Lisa Shapiro, Vice President of Health Policy at First Focus, describes the consumer protections for all children, including children and youth with special health care needs, which will continue now that the U.S. Supreme Court has ruled on the legality of the Affordable Care Act (ACA). Most notably the ACA:

• Prohibits states from rolling back children's eligibility for Medicaid and the Children's Health Insurance Programs (CHIP), which are protected by the  Maintenance of Effort (MOE) requirement of the ACA until 2019;
• Provides grants for states to streamline the eligibility determination and enrollment for Medicaid, CHIP, and the state health exchanges;
• Provides funding to continue outreach and enrollment grants through the Children's Health Insurance Program Reauthorization Act (CHIPRA) to make sure all eligible children are enrolled in Medicaid or CHIP;
• Requires coverage for children's oral health and vision services in the state health exchanges;
• Extends Medicaid coverage for children aging out of foster care until they reach age 26. 

HealthCare.gov
June 25, 2012
Visit this website for information about new services and programs, federal grants received, and the implementation status of the Affordable Care Act (ACA) in each state, territory, and the District of Columbia. There is also a list of partnerships that have been created to enhance the health care workforce, promote public health, support families raising children and youth with special health care needs, and more.

By Mary Agnes Carey
Kaiser Health News
June 28, 2012
On the day President Obama signed the Affordable Care Act (ACA) into law (March 23, 2010), the lawsuits challenging its constitutionality began. Despite the uncertainty about the law's ultimate fate, some provisions, such as the Maintenance of Effort (MOE) requirement, the ban on denying insurance to children with pre-existing conditions, and allowing children receiving hospice care to continue to receive curative treatment went into effect on that day. The elimination of annual insurance caps and other provisions are being phased in over time. Many states are building an infrastructure for the provisions that will go into effect in January 2014, such as the state health exchanges. Now that the ACA has been ruled constitutional, there are many questions about how it will affect individuals now and over the course of the next 18 months. Mary Agnes Carey, a staff writer for Kaiser Health News answers questions about whether or not you have to have health insurance now, your options if you cannot afford it, how a pre-existing condition will affect your ability to purchase a health plan, and more in this FAQ (frequently asked questions) document.

CSHCN Advocacy Groups Issue Joint Statement on ACA Ruling 
Family Voices, the American Academy of Pediatrics, Children's Defense Fund,  Children's Hospital Association, First Focus Campaign for Children, Georgetown University Center for Children and Families, March of Dimes, and Voices for America's Children, issued a joint press release about the U.S. Supreme Court ruling on the Affordable Care Act (ACA). Read their reactions to the ruling and learn more about the assistance the Family-to-Family Health Information Centers can provide to families raising children and youth with special health care needs as the country moves forward with implementation of the national health reform law.

New England Genetics Collaborative Receives HRSA Grant
Congratulations to our partners at the New England Genetics Collaborative (NEGC). They received a new five-year grant award from the Health Resources and Services Administration (HRSA) to continue their work on behalf of individuals with genetic disorders. They began the new project cycle by establishing a Health Care Financing and Access work group, which will be chaired by Meg Comeau, the Catalyst Center director and mother of a young adult with a complex genetic disorder.

The National Center for Medical Home Implementation (NCMHI) has uploaded a series of interviews to its NCMHI YouTube channel. Tune in to listen to providers and family leaders who are medical home advocates talk about the six medical home components. These include care partnership support, clinical care information, care delivery management, resources and linkages, practice performance measurement, and payment and financing.

Date: July 18, 2012
Time: 12:00 noon - 1:00 p.m. EDT
You are invited to participate in this fourth in a five-part webinar series about the Catalyst Center's latest technical assistance tool  Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children's Health Insurance Program (CHIP). This webinar will cover the following sections of the tutorial:

• Section 6: Financing: How Do Medicaid and CHIP Dollars Flow?
• Section 7: Service Delivery Models: How Do States Deliver Health Care Services to Children Enrolled in Medicaid and CHIP?
• Section 8: Quality Measurement and Improvement 

Medicaid and the Children's Health Insurance Programs (CHIP) account for more than 15% of total U.S. health care spending. Where does the money for these programs come from and how is it spent? How does quality measurement and improvement help ensure that children and youth with special health care needs enrolled in Medicaid or CHIP receive high-quality services at a reasonable cost? Participants in this webinar will learn the answers to these questions and more, including information about resources for more state-specific information. Register for this webinar. Listen to recordings of the first three webinars in this series.

Date: July 17, 2012
Time: 3:30 - 5:00 p.m. EDT
This fourth webinar, hosted by the Combating Autism Act Initiative (CAAI), will showcase novel intervention strategies for children with Autism Spectrum Disorders. Register for this webinar.
Listen to the recordings of the first three webinars in this series.

National Center for Ease of Use of Community-Based Services Webinar - Partnering to Make Services Easier to Use for Latino Families with CYSHCN: Examples from Utah
If you were unable to participate on this June 29, 2012 webinar, you can listen to the recording on the National Center for Ease of Use of Community-Based Services website. Learn how parent partners and providers from the University of Utah, the Utah Medical Home Demonstration Project, and the Utah Parent Center developed partnerships with Latino families raising children and youth with special health care needs to increase ease of use of community-based services.

If you have suggestions for news items related to coverage and financing of care for CYSHCN, please email Beth Dworetzky Catalyst Center Coverage editor and Catalyst Center Assistant Director by 12 noon on Friday.