SignUpNow Outreach
Communities Connecting Kids with Health Coverage 
Spring 2013

Welcome to the Spring edition of the SignUpNow Outreach eNewsletter. SignUpNow (SUN) is an initiative of the Virginia Health Care Foundation (VHCF) that is focused on increasing enrollment of eligible uninsured children in Virginia's FAMIS programs. This is the first edition of the newsletter that the most recent SUN training participants have received, so we hope you find it helpful. 

In This Issue
New Outreach Materials Available
Changes to the Federal Poverty Level
Legislative Update
Patient Protection and Affordable Care Act Updates
Facts and Faces

New Outreach Materials Available

Connecting Kids to Coverage is a national outreach and enrollment initiative, funded under the Children's Health Insurance Program Reauthorization Act (CHIPRA) and the Patient Protection and Affordable Care Act (PPACA). The goal of the initiative is to reach out to families with children and teens eligible for Medicaid and the Children's Health Insurance Program (known as the FAMIS programs in Virginia) to:

  • Raise awareness about health coverage available under these programs;
  • Create opportunities for families to get their eligible children and teens signed up for coverage;
  • Motivate parents to enroll their children and teens and renew their coverage;
  • Provide outreach guides and toolkits that can be used to help states, community organizations, schools, health care providers and others organize and conduct successful outreach activities
The Campaign provides outreach materials, training and technical assistance around three waves of activity designed to have a high impact on enrollment and retention of coverage. The three waves include a winter wave, an allergy and asthma wave, and a back-to-school wave. Materials for the winter wave, and the allergy and asthma wave, are available here and can be customized free of charge. The materials for the back-to-school wave are expected in July. The website also includes a copy of a webinar about the types of messages that work best for the target audiences. Additional webinars are expected in the near future. More information can be found at Check it out!

Changes to the Federal Poverty Level

Each year the federal government determines if there is a need to increase the Federal Poverty Level (FPL), and if it decides to do so, the new FPL is published at the end of January. This year, the FPL increased on January 26th. You can download a copy of the new FAMIS Program's income card here

Legislative Update

By Jill Hanken, Virginia Poverty Law Center

While the 2013 short session of the General Assembly was only 45 days long, much was accomplished, especially around the Patient Protection and Affordable Care Act (PPACA).  Back in June 2012, the US Supreme Court allowed states the option of expanding Medicaid for adults. Virginia's Medicaid program currently does not cover childless adults and has one of the lowest income eligibility limits for parents and caretakers (less than 30% of the FPL or under $10,000/year for a family of 4), as well as disabled adults (80% of the FPL or under $800/month). 


During the 2013 Legislative session, the expansion of Medicaid was a key topic for legislators.  The expansion would provide insurance coverage to up to 400,000 uninsured Virginians who have incomes below 138% of the FPL (about $15,800/yr for an individual and $32,500/yr for a family of 4). 


The General Assembly passed budget amendments that allow Medicaid expansion to occur on July 1, 2014, or as soon thereafter as possible, only if a newly created commission of legislators, the Medicaid Innovation and Reform Commission (MIRC), agrees that certain Medicaid reforms have been achieved. While this represents progress towards expansion, it is not guaranteed.


The MIRC will be comprised of 5 members from the House of Delegates, 5 members of the Senate, the Secretary of Finance (non-voting) and the Secretary of Health and Human Resources (non-voting).  Expansion requires affirmative votes by three members from the House and three members from the Senate.  The members of the House of Delegates who will sit on the MIRC are: Steve Landes (R-Augusta); Jimmie Massie (R-Henrico); Dr. John O'Bannon (R-Henrico); Johnny S. Joannou (D-Portsmouth); Beverly J. Sherwood (R-Fredrick).  The Senate members of the MIRC are: Walter Stosch (R-Henrico); Janet Howell (D-Fairfax); Emmett Hangar (R-Augusta); John Watkins (R-Powhatan); and Louise Lucas (D-Portsmouth).


The budget amendments, as amended by the Governor, were officially approved by the General Assembly on April 3rd.  While there is still much work to be done before Medicaid Expansion becomes a reality in Virginia, the 2013 legislature created a path to that end.


For information about the economic value and human impact of the Medicaid expansion, the Commonwealth Institute has produced a range of easy to understand fact sheets which can be viewed on their website.

Patient Protection and Affordable Care Act Updates

One thing is for certain...change is constant, especially when it comes to the Patient Protection and Affordable Care Act (PPACA). While there is still much to be determined regarding the implementation of the PPACA, more and more information is being published each day. As things that will affect your work begin to crystallize, we will keep you abreast of what you can expect. For now, here's what we know:

  • Virginia will participate in the Federally Facilitated Health Insurance Exchange (now being called "The Marketplace"), available to people with incomes at or above 100% FPL. The Marketplace is an online forum, where individuals and small businesses can shop for health insurance, with low-cost and even zero premium plans for those whose incomes qualify. To see a short video describing the Marketplace, click here.
  • Open enrollment in the Marketplace will begin October 1, 2013, and coverage will start on January 1, 2014.
  • There will be a single, streamlined application for the Marketplace, Medicaid and the FAMIS programs. Comments on a draft application were solicited, and the final version of the application should be published by the end of the summer.
  • Eligibility determinations for all of the programs available through the Marketplace will be based, to the maximum extent possible, on income as reported by the applicant and verified through electronic data sources. To that end, a new federal hub, which will tap into the Social Security Administration, the Internal Revenue Service, and the Department of Homeland Security will allow for electronic verification of income, residency and immigration, and citizenship status.
  • The ACA introduces a new income definition-Modified Adjusted Gross Income or "MAGI"-for determining Medicaid/FAMIS income eligibility. This will include three major changes:
    • Use of adjusted gross income as defined in the Internal Revenue Code;
    • A flat disregard of 5 percentage points will be added to the Federal Poverty Level (FPL) instead of applying disregards based on the parent's work status, and child care/adult daycare expenses;
    • Family size and household income will be based on tax filing unit. This is a change from the current methodology used by Medicaid.

VHCF will continue to make you aware of important changes that will affect your work through this publication and through the various listserves supported by VHCF. The SignUpNow training sessions in Fall 2013 will contain information on the new eligibility definitions and the single streamlined applications.

Faces and Facts
Project Connect Outreach Worker recently received a call from a mother who had started an application for coverage for her child through She had completed the application on-line, submitted it and had not received a response. The Outreach Worker requested the mother write a note allowing the Outreach Worker to receive eligibility and enrollment information relating to the application, and then faxed the note to the Central Processing Unit (CPU) that processes applications from The Outreach Worker then contacted the CPU on the mother's behalf and determined that she had mistyped her address. A follow-up letter had been sent to the mother requesting verification documents after she submitted her application, but the mother never received the letter. The Outreach Worker was not authorized to change the address, but they did determine what verifications were missing. The Outreach Worker relayed this information (the need for a corrected address and the verification documents needed) to the mother, and the mother called the CPU to correct her address. The mother faxed the verifications the next day and the child was approved for coverage.


FAMIS Program Enrollment as of February 1, 2013 (most recent data available):

  • 64,552 children are enrolled in FAMIS (including 307 in FAMIS Select);
  • 534,154 children are enrolled in FAMIS Plus (including the CHIP Medicaid Expansion);
  • 1,541 pregnant women are enrolled in FAMIS MOMS;
  • 15,466 pregnant women are enrolled in Medicaid for Pregnant Women; and
  • 36,324 men and women are enrolled in Plan First.
If you have colleagues who would benefit from receiving SignUpNow Outreach, please forward this email to them and encourage them to subscribe to our mailing list by clicking on the "Join our Mailing List" button. We look forward to providing additional information on children's health insurance in the near future.

Polly Raible 
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This newsletter is made possible with support from the Virginia Department of Medical Assistance Services
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