States seek to intervene in House v. Price lawsuit

On May 18, 2017, 15 states and the District of Columbia filed a motion to intervene in House v. Price, a lawsuit threatening the availability of federal funds (about $9 billion in 2017) for cost-sharing reduction (CSR) payments to health insurers under the Affordable Care Act (ACA). The lawsuit pertains to whether or not CSR payments are subject to annual Congressional appropriations. It was initially filed in November 2014 in U.S. District Court, which ruled in favor of the U.S. House of Representatives in May 2016, but held its decision in abeyance pending appeal. It is now before the U.S. Circuit Court of Appeals in the District of Columbia. [More]

Medicaid Member Engagement: One Size Does Not Fit All

There’s a certain catch-phrase going around related to Medicaid members: they need to have “skin in the game.” This phrase seems to imply that individuals receiving Medicaid are somehow different than other individuals—those who have private insurance—but they’re not. Individuals receiving healthcare through Medicaid are just like you and me. They want their children to be healthy and happy. They want to improve their health. They want to live happy and productive lives. However, due to life circumstances, some of them may need a little more assistance than others in understanding the role they play in their healthcare. Effective member engagement can help guide individuals through the complex Medicaid system of care. Medicaid’s population is very diverse and serves individuals from different socioeconomic backgrounds—the aged, blind, disabled, children, pregnant women, relatives taking care of children, and childless adults can qualify for Medicaid if they meet state specific guidelines. Activities to engage Medicaid members in their healthcare need to be as diverse as the population. Mass mailings to the entire population may not be as effective as specific information targeted to a select group of individuals. [More]

The Federal Administration makes ACA-Related announcements

As the Senate continues to craft a repeal package for the Affordable Care Act (ACA), the administration is taking more limited steps to influence implementation of the law, including three announcements this week: Federally-Facilitated SHOP Enrollment. The Centers for Medicare and Medicaid Services (CMS) announced on Monday, May 15, that it will be proposing a rule to have enrollment into Federally-facilitated Small Business Marketplace (known as Small Business Health Options Program or “SHOP”) health insurance plans go directly through insurers as of 2018. [More]

NGA calls for Congressional action on CHIP renewal

On May 11, 2017, the National Governors Association (NGA) released a letter to the Senate Finance Committee and the House Committee on Energy and Commerce calling for Congressional action to renew funding for the Children’s Health Insurance Program (CHIP) for five more years. The letter is signed by Virginia Governor Terry McAuliffe, NGA Chair, and Massachusetts Governor Charlie Baker, NGA Vice-Chair for Health and Human Services. [More]

PCG kicks off powerful, innovative My Brother’s Keeper (MBK) series this week

Join us this Thursday, May 18, for the inaugural session of our MBK Forum series. We are delighted to welcome Mr. Glenn Singleton to speak about “COURAGEOUS CONVERSATIONS ABOUT RACE.”

Mr. Singleton founded Pacific Educational Group (PEG) in 1992, committed to achieving racial equity in education. Glenn and his group engage in sustained partnerships with educational organizations to transform beliefs, behaviors, and results so people of all races can achieve at their highest levels and live their most empowered and powerful lives. COURAGEOUS CONVERSATION™ is their award-winning protocol for effectively engaging, sustaining and deepening interracial dialogue. Through their Framework for Systemic Racial Equity Transformation, PEG is dedicated to helping educators address persistent racial disparities intentionally, explicitly, and comprehensively. [More]

Array of Services - Having It All

Providing families, parents, and children services that support and improve family relationships, family dynamics, and individual responsibilities has always been a primary responsibility of the child protection system. This system is comprised of complicated, intricate, integrated, and interrelated parts, each of which must perform well in order to achieve the ultimate goal: supporting children and families. From the report of a suspicion of abuse or neglect, to the assessment, filing with the court, court hearings, and finally closure, every individual in the process must perform well. [More]

Disrupting the school-to-prison pipeline with trauma-informed, school-based diversion programs

When schools practice harsh discipline and remove students from the school (e.g., through out-of-school suspensions, expulsions, arrests for minor offenses, etc.), it can lead to students’ involvement with the juvenile justice system. This school-to-prison pipeline disproportionately affects minority students, students with mental illnesses and behavioral issues, students with disabilities, and students with histories of abuse and neglect. [More]

PCG creates summary of the House-passed health care bill

The American Health Care Act (“the bill”) passed the House of Representatives on May 4, 2017. As outlined in greater detail in the PCG summary, the bill does not repeal the Affordable Care Act (ACA) in full, but rather proposes changes primarily focused on the ACA’s insurance affordability, Medicaid expansion, coverage requirements and revenue provisions. It also proposes changes to Medicaid funding more generally and allows states to waive medical underwriting prohibitions. [More]

States continue to pursue Section 1332 State Innovation Waivers

With repeal of the Affordable Care Act (ACA) stalled, states are increasingly considering Section 1332 Waivers as a way to expand upon or customize the ACA to best address the unique circumstances within the state. Alaska and Oklahoma are the two most recent states to take formal steps toward State Innovation Waivers, both states following on the heels of the recent Section 1332 Waiver approval granted to Hawaii, which we summarized in the February edition of Health Policy News. [More]