1. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2012). The AFCARS Report: Preliminary FY2011 estimates as of July 2012. Retrieved August 7, 2012 from http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report19.pdf
2. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2011). Child maltreatment 2010. Retrieved May 1, 2012 from http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can
3. American Academy of Pediatrics. (2002). Health care of young children in foster care. Pediatrics, 109(3), 536 -541.
4. American Academy of Pediatrics, District II Task Force on Health Care for Children in Foster Care. (2005). Fostering Health: Health care for children and adolescents in foster care. 2nd Ed. Retrieved June 10, 2011 from http://www.aap.org/fostercare/FosteringHealth.html
5. Waldfogel, J. (2003). Welfare reform and the child welfare system. Children and Youth Services Review, 26(10), 919-939.
6. Berman, S. & Carpenter, S. (2004). Findings brief: Children in foster care and kinship care at risk forinadequate health care coverage and access. Retrieved August 7, 2012 from Changes in Health Care Financing Organization, Academy Health website:http://www.hcfo.org/pdf/findings0704.pdf

The Catalyst Center responds to questions from stakeholders about policies related to coverage and financing of care for children and youth with special health care needs (CYSHCN). On June 28, 2012, the U.S. Supreme Court announced its decision that the Affordable Care Act (ACA) as a whole is constitutional. However, the Court also said that the provision in the ACA that required state Medicaid programs to increase eligibility contained a "coercive" penalty. Therefore, the Medicaid expansion provision is optional. States may choose to implement it, but it is not mandatory for them to do so. Since that time, stakeholders have had questions about the implications of the optional Medicaid expansion for CYSHCN. The following provides some answers.

What is the Medicaid expansion provision and to whom does it apply?

Title II, Section 2001 of the ACA describes Medicaid Coverage for the Lowest Income Populations.1
This provision directs states in 2014 to expand their Medicaid eligibility to include legally residing, non-pregnant, non-disabled individuals, ages 19 to 65, with family income of less than 133% of the federal poverty level (FPL).2 Currently, non-disabled, childless adults between ages 19 and 64 are not eligible for Medicaid in most states regardless of their income. (See the Kaiser Family Foundation State Health Facts chart Medicaid Waiver and State-Funded Coverage Income Eligibility Limits for Childless Adults, 2009 to learn about the status of non-disabled, childless adult coverage in your state.)
Note: With income disregards, individuals can qualify for Medicaid up to 138% FPL. We will use 138% throughout the rest of this document. 

What impact did the U.S. Supreme Court decision have on this ACA provision?

In June, the U.S. Supreme Court issued its ruling on several key questions regarding the constitutionality of the ACA. (See the Catalyst Center's analysis of the ruling.) The Court decided that the ACA as a whole is constitutional - with one exception.

Read on...

1. http://www.healthcare.gov/law/resources/authorities/title/ii-role-of-public-programs.pdf
2. http://aspe.hhs.gov/poverty/12poverty.shtml 

Catalyst Center Medicaid/CHIP Tutorial and Webinar Series

Earlier this year, the Catalyst Center released its 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). The tutorial provides an overview of the state Medicaid and CHIP programs, the many different populations served by them, pathways to eligibility, models for service delivery and quality improvement, and the changes these programs will undergo as the Affordable Care Act (ACA) is implemented. Each section of the tutorial also includes ideas and activities that Title V programs and others might undertake to build partnerships with and improve public benefit programs for children and youth with special health care needs (CYSHCN).

As a follow-up to the release of the tutorial, over the past several months the Catalyst Center has hosted a series of five webinars to introduce it to stakeholders. The goal of the webinar series was to help participants:

• Increase their understanding of state Medicaid and CHIP programs and policies;
• Learn how partnerships with other stakeholders can maximize Medicaid and CHIP program capacity to meet the needs of CYSHCN; and
• Begin to identify specific opportunities to promote partnerships with the Medicaid and CHIP programs in their own state.

The tutorial emphasizes the importance of partnerships among stakeholders in improving coverage and financing of care for CYSHCN. To model the benefits of partnership, we invited a guest to co-present material in each webinar with us. We extend our thanks to our partners at the Maternal and Child Health Bureau (MCHB), the National Association for State Health Policy (NASHP), several state Title V programs, CHIPRA (Children's Health Insurance Program Reauthorization Act) Quality Improvement grantees, the Association of Maternal and Child Health Programs (AMCHP) and the many family leaders who generously shared their time and expertise with our audience.

The objective of this webinar series was to help you understand how to use this new resource in your work on behalf of CYSCHN. During open discussion, which was part of each webinar, participants learned from each other by sharing how they have used the information to build partnerships with Title V, Medicaid/CHIP staff, family leaders, and  other stakeholders to improve health care coverage and financing for CYSHCN. We sincerely thank the webinar audience for their time, attention, and thoughtful questions.

The Aging and Disability Resource Centers (ARDCs) assist individuals with disabilities in identifying the services and supports for which they are eligible. These one-stop resource centers will now also receive some much-needed support. The U.S. Department of Health and Human Services (HHS) is providing $12.5 million to help fund counselors who will help consumers, regardless of income, navigate the system of services and access supports.

Learn more about the ARDCs. Visit the Aging and Disability Resource Center Technical Assistance Exchange to connect with the ARDC in your state.  

In order to focus its efforts on the identification and deportation of individuals who represent a high priority security or public safety risk, the U.S. Department of Homeland Security (DHS) announced a process for Deferred Action for Childhood Arrivals (DACA). As of June 15, 2012, individuals younger than 31 years old, who were brought to the U.S. as children, and certain others, will be considered for "temporary relief from removal." Beginning on August 15, 2012, individuals could apply to DHS for "consideration of deferred action." This letter from Cindy Mann, the Director of the Center for Medicaid and CHIP services, reports the decision by the U.S. Department of Health and Human Services (HHS) with regard to public health coverage. Individuals who remain in the U.S. under DACA are not considered to be "lawfully present;" therefore, they are not eligible for Medicaid or the Children's Health Insurance Program (CHIP).