Washington, DC Update 7/21/23

The two-week sprint until the August recess is on! Appropriations, Defense, the FAA, and so much more to do.

Farm Bill

The Farm Bill is a multi-year law that governs all parts of the nation’s food supply with broad, but often overlooked, consequences for children. The Farm Bill governs access to federal nutrition assistance programs (such as SNAP), environmental and pollution standards for agriculture, farming practices that influence climate change and other areas that pose long-term consequences for the health and well-being of the nation’s children. Reauthorized every five years, the bill’s provisions literally affect the prospects of many generations to come. For more information, check out this one pager by First Focus.

Here are a few highlights:

• SNAP is the nation’s largest federal food assistance program.
• Nearly 90% of SNAP participants are in households that contain a child under age 18, and nearly half of all program participants are children.
• More than 14 million children rely on SNAP for consistent, healthy meals.
• In 2021, SNAP lifted more than 800,000 children out of poverty.
• The average SNAP recipient receives about $5.50 per day in food assistance, which can mean the difference between eating or going without any food in a given day.
• There is concern that this year’s Farm Bill may be used to place more administrative burdens on SNAP applicants and recipients. Currently, only 82% of eligible Americans use their SNAP benefits, largely as a result of excessive administrative burdens. Any effort to layer on more restrictions such as new work requirements will further hurt low income families trying to afford food for their children.

Kaiser Family Foundation: More Disenrollments, Updated Trackers

As states unwind from Medicaid’s continuous enrollment provision, more people are being disenrolled. Twenty-nine states and Washington, D.C. have reported disenrolling almost two million Medicaid recipients as of July 12th. Update KFF Unwinding Trackers.

CMS: All Hands on Deck

The Centers for Medicare & Medicaid Services (CMS) has called for “all hands on deck” approach to the unwinding of the PHE. They are calling for everyone to ensure the following messages get out:

• UPDATE your contact information with your state Medicaid agency NOW.
• RESPOND to the Medicaid renewal form when it comes in the mail. If you don't, you may lose your coverage even if you are still eligible.
• PARENTS should respond even if you are not eligible or are enrolled in other coverage. Your children could still be eligible for coverage.
• CONNECT WITH RESOURCES THAT CAN HELP: If you lose Medicaid coverage and think you may still be eligible, call… ((Insert your F2F/AO name/ contact here)).
• CHECK OTHER OPTIONS: If you are no longer eligible for Medicaid, you should check to see if you can get coverage through your employer or through the Affordable Care Act Marketplace at healthcare.gov.

This CMS page lays out the above with additional information and links. CMS has developed a variety of materials that can used to ensure your communities and networks have this important information. For example, their communications toolkit — available in English, Spanish, Chinese, Hindi, Korean, Tagalog, and Vietnamese — contains important messages and sample materials (like drop-in articles, social media messages, and flyers) for states and other partners to use.

NHELP: Medicaid Renewal Tip of the Day

The National Health Law Program (NHeLP) Medicaid Continuous Coverage Unwinding Team began sending out a Medicaid Renewal Tip of the Day in March 2023. A publication (download here) brings those tips together and organizes by subject; eligibility and redetermination process, notices and appeals, administration, monitoring and compliance. Here is an example of one of the tips:

Don’t Re-verify SSN/Immigration Status (3/28/2023)

Does your state’s renewal form routinely ask for Social Security numbers or immigration status? It shouldn’t! Renewal forms should only request information the state doesn’t already have and that is necessary to complete the redetermination. CMS has made clear that a “form that requests . . . Social Security Number, citizenship or immigration status would not satisfy the requirement. Such information is only needed once and, thus, would not be needed to renew eligibility." (SHO 23-002, FN 20). And removing these questions is important to avoid deterring immigrant families from completing the process.

As the unwinding period continues, NHeLP will continue to update this document. In the interim, advocates can always find the social media version of the tips under #MedicaidRenewal. Learn more about our continuous coverage unwinding work at https://healthlaw.org/unwinding.



Note for F2F/AOs: Consider sharing these tips with families- via social media or other methods of communication!

HHS: Proposed Rule Anti-Discrimination LGBTQI+

The Department of Health and Human Services (HHS) through the Office for Civil Rights (OCR) and the Assistant Secretary for Financial Resources (ASFR) announced a Notice of Proposed Rulemaking (NPRM) to affirm civil rights and equal opportunity for people nationwide in HHS funded programs and services. The proposed Health and Human Services Grants Regulation (HHS Grants Rule), if finalized, would protect LGBTQI+ people from discrimination in important health and human services programs by clarifying and reaffirming the prohibition on discrimination on the basis of sexual orientation and gender identity in certain statutes. This NPRM further builds on HHS’ efforts to ensure access to health and human services in furtherance of President Biden’s Executive Orders on Preventing and Combating Discrimination on the Basis of Gender Identity and Sexual Orientation and Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals

The proposed HHS Grants Rule, if finalized, would clarify and reaffirm the prohibition on discrimination on the basis of sexual orientation and gender identity in federal statutes administered by HHS, consistent with the Supreme Court’s decision in Bostock v. Clayton County, 140 S. Ct. 1731 (2020).

The proposed rule would also confirm non-discrimination protections in HHS programs, including Head Start, as well as services and grants that provide aid to refugees, assistance to people experiencing homelessness, substance abuse treatment and prevention, community mental health services, maternal and child health services, and community services.

The proposed HHS Grants Rule also includes a provision that ensures that those with religious objections may seek an exemption from or modification of program requirements, as appropriate.

HHS encourages all stakeholders, including individuals and their families, health insurance issuers, health care providers, health care professional associations, consumer advocates, and state and local government entities, to submit comments through regulations.gov for 60 days after the announcement, until September 11, 2023.

The NPRM may be viewed or downloaded here.

HHS: Proposed Rule on Childcare

The U.S. Department of Health and Human Services (HHS), through the Administration for Children and Families (ACF), announced a new proposed rule that will help more families access the childcare they need and better support childcare providers in the essential work they do for communities across the country. The proposed rule will lower costs for families, increase financial stability for providers, and reduce paperwork for families trying to access subsidies.

The NPRM proposes changes to:

• Lower Families’ Childcare Costs: Reduces the significant financial strain that high co-payments can cause for families receiving childcare assistance by capping co-payments for all families to no more than 7% of their income and allowing states to waive co-payments entirely for families at or below 150% of the federal poverty level.
• Increase Parents’ Childcare Options and Strengthen Payment Practices: Increases parents’ childcare options by stabilizing operations for participating providers and encouraging more providers to participate in CCDF, ensuring payments are timely and stable and encouraging higher payment rates to better cover the cost of care.
• Reducing Paperwork and Bureaucracy for Parents: Encourages CCDF Lead Agencies to streamline eligibility and enrollment processes to make it easier for families to receive childcare assistance faster and make program bureaucracy less likely to disrupt parent employment, training, and education and impede access to childcare. This includes proposals to allow states to extend presumptive eligibility to families, and encouraging states to allow all families to enroll for CCDF benefits online.

Comments may be submitted for 45 days after publication until August 28, 2023 Federal Register: Improving Child Care Access, Affordability, and Stability in the Child Care and Development Fund (CCDF)

Manatt Health: Whole Child Care

In a webinar titled Strategies for Providing Whole Child Care: A Blueprint for Meeting Children’s Social Needs, Manatt facilitated a panel discussion with state and national leaders who are pioneering new ways to address the health-related social needs (HRSNs) of children, which the Centers for Medicaid & Medicare Services defines as an individual’s unmet, adverse social conditions that contribute to poor health. HRSNs can include but are not limited to food insecurity, housing instability, social isolation and/or lack of reliable transportation. The program also reviewed emerging opportunities for financing children’s HRSN interventions, including 1115 waivers, “in lieu of services” (ILOS), and Children’s Health and Wellness Funds.

In this newsletter article, Manatt answers a handful of questions posed by webinar participants that we did not have the time to address.

To view the full webinar free on demand and download a free copy of the presentation, click here. 

KFF: 988 One Year Later

Since its launch in July 2022, 988 has received almost 5 million contacts. In this new analysis, Kaiser Family Foundation examines state efforts to sustainably fund local 988 crisis call centers and summarize additional metrics that may be useful for monitoring the implementation and performance of the program. Read the full issue brief or a brief summary.

First Focus: Youth-Led Webinar on Mental Health

First Focus on Children invites you to join a virtual, youth-led, policy-focused webinar on the current challenges facing the mental health of our nation’s youth. The webinar will feature young adult leaders in school mental health, foster care, peer-to-peer support, and racial equity who will discuss their experience and share policy recommendations. Senator Tim Kaine of Virginia will provide opening remarks.

Tuesday, July 25, 2023, from 1:00 – 2:00 PM ET Register