Catalyst Center Coverage
Roundup of news related to financing of care for children and youth with special health care needs
 April 23, 2014
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"Happiness is not the absence of problems, it's the ability to deal with them." 

 ~ Steve Maraboli, Life, the Truth, and Being Free
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By Julie Rovner
Shots: Health News from NPR
April 9, 2014   
Initial excitement about the opening of the health insurance marketplaces on October 1, 2013 was marred by technology problems that made it difficult to shop for and enroll in a health plan. When the first open enrollment period ended on March 31, 2014, concerns that no one would sign up were dispelled by President Obama's announcement that more than 7 million people enrolled in marketplace health plans. Despite this initial success, there is room for improvement, and Families USA, a national nonprofit organization working to ensure all Americans have quality, affordable health care, has ten suggestions for Accelerating the Affordable Care Act's Enrollment Momentum. These include additional funding for navigators and other consumer assistors so they can provide the information people need to make informed decisions about enrolling in a health plan and any tax credits and cost-sharing subsidies that might help defray those costs. Families USA also recommends aligning the open enrollment and tax filing deadlines. This would ensure people do not pay multiple tax penalties for being uninsured the previous year as well as for the coming year, because the next open enrollment period, beginning November 15, 2014, is for health insurance coverage beginning January 1, 2015. There is also a need for an improved online tool to help individuals and families estimate the total costs of their health insurance, as too many people estimate costs based on the premiums without factoring in additional out-of-pocket costs due to the deductibles, co-payments, and co-insurance. 
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Webinar: "How Am I Doing?" Measuring State Health Coverage System Performance
 
 
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N1Sebelius Resigns; Obama Names OMB Chief Burwell to Head HHS link2
By Mary Agnes Carey
Kaiser Health News
April 11, 2014
On April 10, Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS) resigned. President Obama, while acknowledging the initial problems with healthcare.gov, credited Sebelius with championing the implementation of the Affordable Care Act (ACA). He also lauded her less-publicized efforts to reduce health care inequities, improve maternal and child health, and increase access to mental health services. The President has nominated Sylvia Burwell, the director of the Office of Management and Budget (OMB), as the new HHS Secretary.

 

N2Smaller Premium Hikes Forecast in 2015 for Obamacare link2  

By Jennifer Haberkorn and Brett Norman
Politico
April 14, 2014
The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) have released new estimates about the cost implications of the Affordable Care Act (ACA) and its impact on coverage. Projections include: 

  • In 2014, 12 million more people have insurance because of the ACA
  • In 2015, insurance premiums will rise less than 3%, a lower-than-expected increase
  • Over the next 10 years, the federal government's cost for health coverage will be $104 billion less than projected
  • Over time, the Qualified Health Plans (QHPs) sold through the marketplaces will look more like typical employer plans
  • The risk corridor program, a temporary program designed to stabilize QHP premiums and even out insurers' gains and losses, will be cost neutral
By Shaun Heasley
Disability Scoop
April 2, 2014
The value of real estate and access to mental health providers both depend on location, location, location. A new report from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute documents disparities in access to care. Nationwide, the ratio of mental health providers to patients is 1:1,620, but individuals living in the Northeast and Western parts of the country have greater access to psychiatrists, psychologist, and other mental health providers than individuals in other parts of the country. Access the County Health Rankings & Roadmaps: Building a Culture of Health, County by County report.  
 
By Geoff Pender 
Clarion Ledger 
April 8, 2014
The University of Mississippi Medicaid Center (UMMC) and Mississippi Children's Home Services (MCHS - a nonprofit organization accredited by the Mississippi Departments of Human Services, Mental Health, Medicaid, and Education and Health and Human Services) are working together to ensure the one in five children in the state who need mental and behavioral health services, receive the care they need. An additional partnership between the Centers for Medicare and Medicaid Services (CMS) and the Mississippi Division of Medicaid is providing the funding for this multiagency initiative. This goals of the Children's Collaborative are to streamline the state's fragmented mental and behavioral health system, improve access to care, and support primary care providers in making informed decisions about the need for and referrals to behavioral and mental health providers.  
 
By Robert Preidt 
Medline Plus
April 10, 2014
Children in foster care are at increased risk for poor physical, developmental, and mental health. A recent study also notes children in foster care are at increased risk of being treated with antipsychotic drugs. This is a disturbing trend, as these drugs are being prescribed to one-third of children in foster care with ADHD (Attention Deficit Hyperactivity Disorder). The U.S. Food and Drug Administration has not approved these medications for the treatment of ADHD, so this practice is not evidence-based. Children are being medicated rather than receiving needed behavioral health services.
 
By Cindy Y. Rodriguez and Jaqueline Hurtado
CNN U.S.
April 9, 2014
Deferred Action for Childhood Arrivals, also known as DACA, provides a stay of deportation for young people (younger than 31) who:
  • Entered the United States prior to turning 16 years old
  • Have been living here since June 15, 2007 without documentation or whose immigration status expired as of June 15, 2012
  • Are in school or have  graduated from high school
  • Honorably served in the Coast Guard or military
  • Do not pose a threat to national security

Because individuals with DACA status are not lawfully present in this country, they are not eligible for Medicaid, the Children's Health Insurance Program (CHIP), or marketplace coverage. If passed, the Health Equity & Access under the Law (HEAL) for Immigrant Women & Families Act of 2014 (H.R. 4240) would allow DACA grantees to be eligible for Medicaid, CHIP, and subsidized marketplace coverage. Realizing that providing preventive services is more cost effective than paying for emergency care, California and New York, states with large numbers of undocumented immigrants, are using state funds to provide Medicaid to this population. Massachusetts, Minnesota, Washington state, and Washington D.C. also use state or district dollars to provide health insurance to individuals with deferred status whose household income is limited.     

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Resources
  
Julie Sonier and Brett Fried
State Health Access Data Assistance Center (SHADAC)
April 2014
Between 2008 and 2012, the percent of uninsured children in the U.S. declined from 9.7% to 7.5%. Researchers at SHADAC  attribute the improved coverage to increased enrollment in Medicaid and the Children's Health Insurance Program (CHIP). This is just one of several encouraging trends in children's coverage. Sonier and Fried also found that coverage inequities based on household income, race, and ethnicity have decreased. The report includes a description of data sources and methods, state tables and fact sheets.  

 

News From Our Partners 
 
The Bright Futures Family Pocket Guide is an engaging, family-friendly companion to the American Academy of Pediatrics (AAP) Bright Futures: Guidelines for the Health Supervision of Infants, Children, and Adolescents (3rd ed.). The Pocket Guide was developed by families for families to promote family/provider partnerships for children's health care and to provide information about child development and ideas for promoting health and wellness for children, including children with special health care needs, and much more. The Pocket Guide is now available in Spanish.

April is National Minority Health Month. Recognizing that preventive health services are integral to reducing health disparities, the Office of Minority Health within the U.S. Department of Health and Human Services (HHS) has chosen Prevention is Power: Taking Action for Health Equity as this year's theme.  Kathleen Sebelius, former HHS secretary, noted the health disparities between minorities and non-Hispanic whites and stated that HHS is working towards "a nation free of disparities in health and health care." The Office of Minority Health is hosting a series of Health Equity webinars. Learn about upcoming events and access the slides and recordings of Health Equity webinars that took place earlier this month.  
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Events & Announcements

Date: April 23, 2014
Time: 2:00 - 3:30 pm ET
The Affordable Care Act (ACA) has created new pathways to health insurance. Data collection and the use of performance measures, as well as the development of new standards, help states monitor and improve the current and new systems of health coverage. This webinar, hosted by the National Academy for State Health Policy (NASHP) is an opportunity to hear how California, Connecticut, and Idaho use data and have developed performance measures to make data reports publicly available, monitor the marketplace, and track enrollment and retention as a benchmark for understanding the implementation of the ACA. Register for the "How Am I Doing?" Measuring State Health Coverage System Performance webinar. 

Date: April 24, 2014
2:00-3:00 pm ET
Section 2703 of the Affordable Care Act (ACA), the Medicaid Health Home Provision, is an opportunity for states to integrate physical and behavioral health needs for Medicaid-eligible individuals with chronic conditions. States that create a Medicaid state plan amendment receive a 90% federal match for health home services, but only for two years. This webinar, hosted by the Center for Health Care Strategies, is an opportunity to learn how Missouri and New York are working to sustain their Health Homes and other lessons learned. Register for the Seizing the Opportunity: Early Medicaid Health Home Lessons webinar. 
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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 Project Director by 12 noon on Friday.
The Catalyst Center is a national center dedicated to working with states and stakeholder groups on improving health care insurance and financing for Children and Youth with Special Health Care Needs (CYSHCN). For more information, please visit us at www.catalystctr.org or contact Meg Comeau, Co-Principal Investigator, at mcomeau@bu.edu.

The Catalyst Center is funded under cooperative agreement #U41MC13618 from the Division of Services for Children with Special Health Needs, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. Kathleen Watters, MA, MCHB/HRSA Project Officer. The contents of Catalyst Center Coverage are solely the responsibility of the authors and do not necessarily represent the views of the funding agencies or the U.S. government.