As part of its mission, the Mid-Atlantic Association of Community Health Centers (MACHC) engages in advocacy efforts at the state and federal levels on behalf of its members and promotes public policy that expands access to health care services and improves health care outcomes for vulnerable populations and underserved communities. The Association's advocacy program is designed to communicate the needs of Community Health Centers to state and federal elected and appointed officials in concert with other health care providers. As the “Voice of Communities in Need" throughout the state of Maryland and Delaware, MACHC partner's with the National Association of Community Health Centers (NACHC) and key strategic partners to advocate on behalf of its members, to further support Federal and State legislation that increases healthcare access to the underserved. Services provided through the Advocacy program include working with lawmakers at the State Capitol, meeting with Members of Congress in Washington, D. C., and providing critical information to opinion leaders in the media and policy makers to support expanding access to primary care services.

Advocacy Updates and Information
The Exchange legislation meeting that was convened by the Administration last Friday, was the commencement of a series of meetings regarding the legislation and Maryland’s ultimate direction on implementation of reform.  As indicated last week, the primary focus of MACHC’s interests should be on the role and structure of the navigators.  This is the area of the bill that generated the most discussion and will undoubtedly be the focus of much of the continued debate.  The next meeting is scheduled for Friday, February 10^th at 1:00 pm.

Legislation intended to address the issue of access to medical care for unaccompanied minors (House Bill 68 (Medical Treatment – Youth – Registered Nurses, Physician Assistants, and Licensed Social Workers) was heard in the House Health and Government Affairs Committee on Tuesday.  This is not a scope of practice bill but rather a bill requiring significant amendment to achieve the objectives of the sponsor.  A workgroup was held this morning, to begin to craft appropriate amendments.  The focus of the workgroup’s discussion was the development of language that defines “unaccompanied minor” and provides those youth with the same right to consent to medical care as an adult.  It remains a work in progress. 

Senate Finance, Senate Budget and Taxation, House Health and Government Operations and the Health and Human Services Subcommittee of the House Appropriations Committee all had briefings on the implementation of federal health reform and the Medicaid program budget initiatives.  Given the State’s fiscal challenges, protection of the enhanced revenues to the Medicaid program will need focused attention. 

The Community Health Resource Commission’s budget hearings will be held on Monday, February 6^th in the Senate and Wednesday, February 8^th in the House.  I will prepare testimony for MACHC to provide in support of the Commission and its ongoing efforts.  The BRFA legislation which addresses statutory changes to funding will be heard later in the Session.  Fortunately this year’s BRFA does not include a statutorily imposed “cap” to the Commission’s funding and actually proposed to add $4 million in additional funding to by utilized in conjunction with the Governor’s health disparities initiative.

The following link will take you to the Maryland General Assembly Web Site, where you can access Synopsis, Calendars, Bill text, Bill status, Legislator contact information and much more.  For this and prior sessions, click here: http://www.mlis.state.md.us

White House FY2012 Budget Highlights 
The President’s budget for Fiscal Year 2012 calls for $79.9 billion in discretionary spending to support programs administered by HHS, which is slightly above the 2010 funding level. Within this level, the Department is taking on significant new responsibilities with the implementation of the Health Care Reform’s Affordable Care Act (ACA) and the new food safety law, as well as strengthening program integrity. Within the funds available to HHS, are $6.8 billion for the Health Resources and Services Administration (HRSA), an Agency within HHS charged with increasing access to basic health care for those who are medically underserved. One of the primary goals of the HRSA budget is to improve both access to and quality of health care in rural and medically underserved areas, as well as increase the number of doctors, nurses, dentists and other health professionals.

Expanding Access to Coverage and Making Coverage More Secure:
The Affordable Care Act expands access to affordable coverage to millions of Americans and strengthens consumer protections to ensure individuals have coverage when they need it most. These reforms create an important foundation of patients’ rights in the private health insurance market and put Americans in charge of their own health care. As a result, historic private market reforms have already begun, including eliminating pre-existing condition exclusions for children; prohibiting insurance companies from rescinding coverage and imposing lifetime dollar limits on coverage; and enabling many adult children to stay on their parent’s insurance plan up to age 26. The Affordable Care Act also established new programs to lower premiums and support coverage options, such as the Pre-Existing Condition Insurance Plans Program and the Early Retiree Reinsurance Program. The Act provides Medicare beneficiaries and enrollees in most private plans access to free preventative services. Medicare beneficiaries also have increased access to prescription drugs under Medicare Part D by closing the coverage gap, known as the “donut hole,” by 2020 so that seniors no longer have to fear being unable to afford their prescriptions. The Act also provides for an annual wellness visit to all Medicare beneficiaries free of charge.

Beginning in 2014, State-based health insurance Exchanges will create affordable, quality insurance options for many Americans who previously did not have health insurance coverage, had inadequate coverage, or were vulnerable to losing the coverage they had. Exchanges will make purchasing private health coverage easier by providing eligible consumers and small businesses with “one-stop-shopping” where they can compare a range of plans. New premium tax credits and cost-sharing reductions will also increase the affordability of coverage and care. The Affordable Care Act will also extend Medicaid insurance to millions of low-income individuals who were previously not eligible for coverage, granting them access to affordable health care.

Click Here to see the President's Budget for Fiscal Year 2012.

Health Reform Debate
As of December 24, 2009 both the House of Representatives and the Senate have passed their versions of the Health Reform legislation. Click on the links below to view the Congressional Records and legislative summaries.

H.R.3962 - Affordable Health Care for America Act (House)
H.R.3590 - Patient Protection and Affordable Care Act (Amendment in Senate)  (Senate)

Links to Resources

Kaiser Family Foundation website on Health Reform offers in-depth analysis and comparison of the various legislation. Click here to view the Kaiser Health Reform website.

The National Council for Community Behavioral Healthcare has provided a side-by-side comparison of both pieces on legislation. This chart summarizes provisions most pertinent to community behavioral health providers, including general insurance market reforms, expansion of Medicaid eligibility, and workforce and other provisions that are specifically targeted to the mental health and addiction fields; however much of the summary is applicable across community health.  Click here to view the side-be-side chart by the National Council. 

How to get involved in the Health Reform Debate
Several of the bills that have been introduced in Congress on Health Reform include significant gains for Federally Qualified Health Centers (Affordable Health Choices Act calls for nearly a 200% increase in FQHC funding by 2015, among other items). If you want to show your support for Health Reform legislation that supports the good work already being done by our community health centers consider writing an Op-Ed or a Letter to the Editor on the topic. The National Association of Community Health Centers has developed two easy to use templates for this purpose. Click here to access the Letter to the Editor or Opinion-Editorial (word documents). These documents can easily be amended to represent your local community health center. 

For more information on the associations current and future legislative initiatives please contact Duane Taylor at duane.taylor@machc.com or call 301-577-0097.