Greetings Healthy Kids Action Network!

Last week was a busy week for children's health advocates!

We witnessed a historic moment with the passage of health reform legislation followed by the reconciliation package, or "fix" bill. Be sure to reach out and thank the Michigan Congressional members who voted in support of the legislation! A roll call vote can be found on our health care reform page.

Additionally, the Department of Community Health (DCH) budget cleared the first chamber when it was passed by the Senate 21-16, mostly along a party line vote. It is built on continued cuts from the current budget year, additional cuts, and no new revenues to support basic services.

You MUST continue to reach out to your senators and representatives to urge protection of vital services and to find the needed revenue to fund these programs.

It is important to note that health care reform legislation will have a significant impact on the state budget decisions that are made. For example, there are maintenance of effort provisions for CHIP and Medicaid eligibility levels that must be met.

In this email you will find highlights of the health reform legislation as it relates to children, along with a short summary of the DCH budget as passed by the Senate.

Please do not hesitate to contact me if I can be of any assistance.

Best,

Alicia S. Guevara
Policy & Outreach Associate

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act, and is scheduled to sign the reconciliation "fix" bill today.

Health reform legislation contains several provisions benefiting children and families. Highlights include:

• Maintenance of current funding levels for CHIP through 2015;
• Expansion of Medicaid to 133 percent of the federal poverty level;
• Increase of payments to primary care doctors in Medicaid;
• Establishment of a home visiting program providing $1.5 billion over five years;
• Creation of an authorizing bill for future funding for school-based and school-linked health centers, and $200 million in competitive grants for renovation and construction for existing centers; and,
• Requirement for states to maintain current eligibility standards for Medicaid and CHIP for children through September 30, 2019 (January 1, 2014 for adults).

In addition, by the end of September insurers be:

• Prohibited from denying coverage to children with pre-exising conditions;
• Prohibited from imposing lifetime limits or "unreasonable" annual limits for any beneficiary, particularly important for children with severe and chronic medical conditions;
• Prohibited from being able to drop coverage due to an illness;
• Prohibited from charging cost-sharing requirements for preventive services and screenings listed below;
• Required to provide coverage to unmarried dependents up to the age of 26; and,
• Required to provide the following preventive services as they relate to children:

On March 24, 2010, the Senate passed its version of the fiscal year 2011 DCH budget. The Senate bill totals $13.5 billion--approximately $830 million below the Governor's proposed budget. Of this total spending, the Senate uses $1.92 billion of state general fund dollars, which is almost 17 percent below the current year budget.

Among cuts continued from the current fiscal year into the FY 2011 budget are:

• Elimination of funding for the 0 to 3 Secondary Prevention Program ($524,000);
• Elimination of funding for prenatal care outreach and service delivery support ($3.24 million);
• Elimination of funding for the Nurse Family Partnership ($1 million);
• Elimination of respite care services for children with severe emotional disturbances and their families ($1 million);
• Significant cuts to pregnancy prevention and family planning programs ($4 million across several budgets); and,
• Deep cuts to Medicaid provider reimbursement rates of 8 percent, increasing barriers to access for low-income people.

Highlights from the Senate passed DCH budget include:

• Elimination of funding for Medicaid coverage for 19- and 20-year olds effective July 1, 2011 ($2.1 million);
• Increased funding for reimbursements for MIChild dental services (required by CHIPRA);
• No expansion of MIChild eligibility or services as provided by CHIPRA;
• Transfer responsibility for MIChild to Medicaid HMOs to save $2.19 million;
• Decrease funding for the Healthy Michigan Fund ($5 million), and rolled it up into one line-item requiring the department to make allocations to local communities;
• Rejected the Governor's proposal to eliminate funding for the Arthur Hill High School and Mumford High School clinics ($164,000);
• Elimination of funding under the Children's Special Health Care Services (CSHCS) for genetic counseling ($40,000) and human growth hormone therapy ($2 million) for Title-V eligible families;
• Elimination of funding for the Child Care Enhancement Program (CCEP), a mental health program for children ages 0 to 3 ($1 million); and,
• Limited the Governor's recommendation to cut funding for local public health operations to $1 million (Governor proposed a $2.7 million decrease).

The Senate also rejected the Governor's revenue proposed to implement a physician quality assurance assessment program (QAAP), but recommended cuts to Medicaid physician reimbursement rates by 4 percent except for primary care, pediatric, obstetric, and emergency services.

A more detailed Budget Basics report will be available soon. Check out our health legislative priorities for the FY 2011 budget.