Catalyst Center Coverage
Roundup of news related to financing of care for children and youth with special health care needs |
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Quote of the Week
"When it is obvious that the goals cannot be reached, don't adjust the goals, adjust the action steps."
~ Confucius
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Featured Article
PR Newswire
Washington Business Journal
May 16, 2014
Before the passage of the Affordable Care Act (ACA), children enrolled in Medicaid whose life expectancy was less than six months could receive hospice services. However, once they elected hospice, they could no longer receive curative care. Section 2302 of the ACA, titled "Concurrent Care for Children," allows children to receive both hospice and curative care. While families no longer have to forgo curative care for a child with a terminal illness, the child still must be in the last six months of life before enrolling in hospice. H. R. 4605, the Children's Program of All-Inclusive Coordinated Care (ChiPACC) Act of 2014, recognizes that children with life-limiting illnesses and their families need counseling, palliative, respite, and other services from the moment their child receives a diagnosis. If passed, this federal legislation would make it easier and faster for states to provide a full range of coordinated support services. States that have already created a ChiPACC waiver report an "average savings of $1,500 per child, per month." |
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 IN THIS ISSUE
News Items
Resources
Events and Announcements
In Case You Missed It...
So, what do you think about
Catalyst Center Coverage?
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News Items
Arizona Offers "Sneak Peak" at Costs of Shifting Kids off CHIP 
By Phil Galewitz
Kaiser Health News
May 8, 2014
Of the 120,000 Arizonans who purchased marketplace health plans during the first open enrollment period, 21% were younger than 18, giving Arizona the distinction of enrolling the highest percent of children in marketplace coverage. Arizona also has the distinction of being the only state to end its Children's Health Insurance Program (CHIP). But at what cost to families? Advocates are concerned that marketplace coverage will provide fewer health services for children at higher costs for families. In addition, the "family glitch," which results because the affordability of employer-sponsored insurance is based on the cost of the health premium for just the employee and not the family, will preclude some families from receiving the federal subsidies that make marketplace coverage more affordable. Advocates are also concerned that what they are seeing in Arizona may be a preview of what will happen nationally. Funding for the CHIP program ends in October 2015. If Congress does not reauthorize continued funding, more children may transition from CHIP to marketplace coverage.
Gaps in Kids' Dental Coverage a Trouble Spot
By Marissa Evans
Kaiser Health News
May 19, 2014
Can teeth be the root of other health problems? The American Academy of Pediatric Dentistry (AAPD) says "yes." Its report, The State of Little Teeth, explains how poor oral health can put children at risk for general health problems such as earaches, diabetes, malnutrition, and heart disease. Lack of dental care can affect children's intellectual and social development and can cause disability and even death. Pediatric dental services are included in the Affordable Care Act's (ACA) essential health benefits, but the law allows for the sale of standalone dental plans inside and outside of the marketplaces. There are no federal subsidies to help defray the cost of dental insurance. Depending on the state, purchase of a standalone dental plan can mean families will pay extra premiums, additional deductibles, and separate out-of-pocket costs. A study by the American Dental Association found that only 34% of health plans sold in the 36 federally facilitated marketplaces included pediatric dental benefits. There is also huge state-to-state variation in the cost of dental plans sold on the federal marketplaces. Unlike the individual mandate for medical insurance, there is no mandate for dental insurance. All of these factors contribute to concern that children will not receive the dental care they need to ensure their overall health and well-being.
By Carolyn Duff
National Association of School Nurses
May 2014
Win-win-win may sound like a cheer for a school sports team, but it's also what happens when a school nurse is part of every student's educational team. May 7 was National School Nurse Day. This letter, from the president of the National Association of School Nurses, pays tribute to the more than 70,000 school nurses who monitor individual students' health and the population health of the school community. School nurses manage the health and well-being of students, including students with chronic illnesses, in non-medical settings so each child is healthy and ready to learn and can participate as fully as possible in the life of the school community.
By Robert Pear
The New York Times
May 14, 2014
Sylvia Mathews Burwell, director of the Office of Management and Budget, is President Obama's nominee to succeed Kathleen Sebelius as Secretary of the U.S. Department of Health and Human Services. Sebelius announced her resignation on April 10, 2014, but remains in her position until Congress confirms a new Secretary. According to this article, Sebelius's retirement may come as early as Memorial Day weekend. After a positive session before the Senate Committee on Health, Education, Labor and Pensions, Burwell had "another cordial congressional hearing" on May 14.
By Juliet Eilperin
The Washington Post
May 16, 2014
President Obama wants to make sure his administration learns from its mistakes. To ensure that history does not repeat itself, the President has appointed Kristie Canegallo as his deputy chief of staff for policy implementation. Canegallo helped monitor data from and "salvage" healthcare.gov, the online federal marketplace after the difficult launch in October 2013. She will apply lessons learned to the continued implementation of the Affordable Care Act (ACA).
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Resources
By Tricia Brooks, Martha Heberlein, and Joseph FuGeorgetown University Center for Children and Families and the Children's Action AllianceMay 2014There is some uncertainty about the future of the Children's Health Insurance Program (CHIP) in the era of health reform. CHIP is funded through October 2015. Arizona has already phased out its CHIP program and moved children into marketplace coverage. The authors examined benefits, including dental benefits in standalone plans and cost-sharing for three real-life children, one with complex health needs, in qualified health plans in the marketplace. The report also discusses the policy implications if CHIP funding is discontinued.
By Anita Cardwell, Joanne Jee, and Catherine Hess at the National Academy for State Health Policy and Joe Touschner, Martha Heberlein, and Joan Alker at Georgetown University Center for Children and Families
May 2014
The authors interviewed Children's Health Insurance Program (CHIP) directors and staff and examined the benefits, cost-sharing, and service delivery model for the 42 separate CHIP programs. In general, families incurred limited or no premiums for their children's CHIP coverage with limited or no cost-sharing for services. The majority (81%) of CHIP programs enrolled children in managed care. This report provides a review of each state's benchmark plan, covered services, and service limits.
News From Our Partners
National Prevention Week
E-Learning Program for Oral Health Professionals on Cultural and Linguistic Competency
As noted in the News Items above, many children are not receiving needed oral health services. In particular, racial and ethnic minority youth are more likely than white youth to be uninsured and to have unmet oral health needs. In order to alleviate the inequities in oral health, the Office of Minority Health has an e-learning program where oral health professionals can develop the knowledge and skills to improve the oral health of diverse populations. Learn more about providing culturally and linguistically appropriate oral health care. |
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Events & Announcements
Date: May 29, 2014
Time: 1:00 pm ET
Open enrollment for marketplace coverage closed on March 31; the next open enrollment begins on November 15, 2014. However, individuals who experience certain qualifying life events, such as getting married or turning 26 and losing coverage through a parent's plan, have 60 days to apply for a special enrollment period and obtain new coverage. This webinar, hosted by the Health and Human Services (HHS) Partnership Center, is an opportunity to learn about special enrollment periods and how to enroll in the marketplaces. There will also be a discussion about resources for individuals without insurance who do not qualify for a special enrollment period. If you have a question that you'd like answered, e-mail your question to ACA101@hhs.gov by 10 am ET on May 29.
Date: May 29, 2014
Time: 2:30 - 4:00 pm ET
Date: June 4, 2014
Time: 2:00 pm ET
Due to the Affordable Care Act (ACA), many people now have health insurance that did not have it before. This webinar, hosted by the Health and Human Services (HHS) Partnership Center, is an opportunity to learn how to use your insurance, read your insurance card, find a doctor, make a doctor appointment, and know what to do in the event of a health emergency. If you have a question that you'd like answered, e-mail your question to ACA101@hhs.gov by noon ET on June 4. |
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Want more news?
To view more articles from past issues of Catalyst Center Coverage, visit the Catalyst Center website. For state-specific news, visit the Catalyst Center Facebook page.
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News to share?
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.
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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.
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