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Washington DC Update 3/3/2021
Greetings. The main topics covered in this Update are:

REMEMBER New Special Enrollment Period (SEP): Feb. 15 - May 15 
See the ACA section below for more information and tools to spread the word, such as this easy-to-understand fact sheet from the Young Invincibles.

Late Friday night (actually, early in the morning of Saturday, February 27), the House of Representatives passed the “American Rescue Plan Act of 2021” (H.R. 1319). All but two Democrats voted for the bill, and no Republicans did so. (Roll call vote.) The bill includes some largely temporary health-related and other provisions that will help families, including:
•      $1400 stimulus payments to individuals, including adult dependents;
•      Medicaid funding dedicated to home and community-based services;
•      A state option to provide 12-month-postpartum Medicaid eligibility (for 5 years);
•      Medicaid coverage for vaccines and COVID treatment;
•      Incentives for states to take up the ACA Medicaid expansion;
•      Subsidies for COBRA coverage;
•      More generous ACA premium tax credits;
•      Funding for public health, including community health centers, the public health workforce, mental health and substance use services, tribal health centers, and the Indian Health Service;
•      Emergency paid leave for certain businesses;
•      An increase in the child tax credit;
•      State Medicaid and CHIP programs coverage of COVID-19 vaccines and treatment without cost-sharing, with full federal funding for vaccines; and
•      Funding for states and localities to help them avoid cuts in essential services.
See House-Passed American Rescue Plan Act Would Spur Medicaid Expansion and Promote Maternal Health (Blog of the Georgetown Center for Children and Families, 03/01/21)
The Senate is expected to take up an amended version of the bill as early as Wednesday, March 3. That bill can be further amended on the Senate Floor.

See Senate set to take up $1.9T Covid aid bill as soon as Wednesday (Politico, 03/01/21). The Senate parliamentarian has advised that the House bill’s $15-per-hour minimum wage provision does not comport with the Senate’s “Byrd rule,” which requires that all provisions in “reconciliation” bills be budget-related. (The reconciliation process is being used for this legislation because there is not enough bipartisan support for the bill to get the 60 votes needed to advance legislation “under regular order.”)

Unless the Senate should decide to ignore the parliamentarian’s advice, which would be a dramatic departure from precedent, that provision will have to be dropped or changed. The parliamentarian may determine that other provisions of the bill also violate the Byrd rule. Still other provisions may be changed because moderate (more conservative) Democrats may object to them. For example, they may seek to more narrowly target the $1400 stimulus payments. Given the 50-50 Democrat-Republican split in the Senate, with the vice-president breaking tie votes, a single Democrat can have a great deal of influence over legislation. The goal is to have the bill enacted by March 14, when special pandemic-related unemployment benefits are due to expire.
Medicaid & CHIP
This resource guide identifies federal and state Medicaid flexibilities available during COVID-19 to help ensure access to LTSS.
The Health 202: The pandemic has nudged millions of Americans into Medicaid (02/03/21). Because no one can be disenrolled from Medicaid during the Public Health Emergency (PHE) caused by the coronavirus pandemic, states will face challenges after the PHE in determining who is eligible to remain enrolled and who isn’t.
Affordable Care Act/Private Insurance
(blog of the Georgetown Center on Health Insurance Reforms, 02/24/21)
Special Enrollment Period (SEP): Feb. 15 - May 15
This new SEP applies to the 36 states using the Healthcare.gov exchange or platform. Other states may choose to open their enrollment periods. These states and their enrollment periods are listed on page 2 of this fact sheet from the Young Invincibles – New COVID Open Enrollment Period: An Explainerwhich also provides suggested media messages. 

Community Catalyst has additional Social media graphics and digital content and a social media messaging guide and are NEW graphics for this SEP.
NEW Resources related to the Special Enrollment Period:
This document provides technical guidance for Marketplace stakeholders and answers to frequently asked questions about the 2021 Special Enrollment Period (SEP).
CMS also released a memo listing the specific dates and times for regular maintenance of the Healthcare.gov website through May 15, 2021. During these times, the site’s information about plans will be available, but the application and enrollment tools will not be functioning.
Resources from AMCHP
The Association of Maternal and Child Health Plans (AMCHP) has developed materials related to the Special Enrollment Period in the 36 states that use the HealthCare.gov platform – a consumer fact sheet in English and Spanish, and a fact sheet for MCH professionals
FDA Authorizes Emergency Use of Johnson & Johnson Vaccine

On February 27, the Food & Drug Administration (FDA) granted Emergency Use Authorization (EUA) for administration of the vaccine developed by Janssen (Johnson & Johnson) to individuals age 18 and older. 

Vaccine Allocation for Non-Elderly People with Disabilities or Special Health Care Needs and their Caregivers:
  • COVID-19 Vaccine Access for [Non-Elderly] People with Disabilities (Kaiser Family Foundation Issue Brief, 03/01/21). This issue brief includes state-level data that could help to inform state policy-makers about the need to vaccine non-elderly people with disabilities who are not residing in nursing homes or assisted-living facilities, and their caretakers.

WORTH REPEATING: The Next Phase of Vaccine Distribution: High-Risk Medical Conditions (KFF Feb 16, 2021) (Finds that states are all over the map, so to speak, regarding which conditions qualify someone to get a vaccine.); summarized in 37 States Explicitly Outline What Conditions are Considered “High-Risk” for Vaccine Prioritization (Kaiser Family Foundation, 02/24/21)
Other News & Resources
The last Update reported that the CDC announced an extension of its residential eviction moratorium until at least March 31, 2021. On February 25, however, a federal judge in Texas sided with landlords and property managers in ruling that the commerce clause of the constitution does not authorize Congress to grant CDC the power to halt evictions. (The decision does not affect states’ authority to control evictions.) The case will likely be appealed to the Texas-based U.S. Court of Appeals for the 5th Circuit.
The Federal Communication’s Commission has established an Emergency Broadband Benefit, which will provide a discount of up to $50 per month towards broadband service for eligible households and up to $75 per month for households on Tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers if they contribute $10-$50 toward the purchase price. The benefit is limited to one monthly service discount and one device discount per household. The start date of the program has not yet been established.

Please check this page for eligibility details and program updates.
RAISE Family Caregiving Advisory Council: January 2021 Meeting Summary (National Academy for State Health Policy, 02/22/21) 

WORTH REPEATING: The National American Indian and Alaska Native Mental Health Technology Transfer Center Network's K-12 School Initiative offers a year’s worth of free telehealth mental health services to children and youth in grades K–12. The services will allow children and adolescents to connect via cell phone with counselors, therapists, or social workers. Interested providers who work in school or community health care programs for Native youth are encouraged to email Teresa Brewington for more information.
CMS Coronavirus (COVID-19) Partner ResourcesThis resource page provides links to numerous resources from the CMS, HHS, and CDC related to COVID-19 and COVID-19 vaccines.
From the Centers for Disease Control and Prevention (CDC):
  • Updated its guidance and tools to help tribal organizations make decisions, communicate with their members, and protect their families and communities.

  • Coronavirus Self-Checker is an online, mobile-friendly, interactive clinical-assessment tool to assist people in deciding when to seek testing or medical care if they suspect that they or someone they know has contracted COVID-19 or has come into close contact with someone who has COVID-19.

  • For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19Updated resources about MIS-C, a condition causing inflammation in many body parts, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care.

TRICARE and Military Health System
Tricare updates since the last Washington update:

To keep up with TRICARE and COVID-19 updates, sign up for email alerts.
Download the latest TRICARE East Region or TRICARE West Region newsletter at www.tricare.mil/publications.
The Arc’s Center for Future Planning
La Planificación Futura: Es Posible y Necesario,” will be offered twice:
More information here in Spanish about this webinar and other future planning resources.
Wednesday, March 3, 2:00 ET
American Association of People with Disabilities; New America
Thursday, March 4, 3:00-4:00 ET
Applied Self-Direction
NEW Bridging the Digital Divide for HCBS Beneficiaries (Parts I and II)
Administration for Community Living and the Centers for Medicare and Medicaid Services
NEW Medicaid Forward: Behavioral Health Launch (about a report providing evidence-backed, sustainable policies to improve Medicaid members' mental health and well-being)
Friday, March 5, 11:00-12:00 ET
National Association of Medicaid Directors
Friday, March 5, 2:00 ET
National Conference of State Legislatures

Robert Wood Johnson Foundation Systems for Action Research Program
National Family Support Technical Assistance Center
NEW Medicaid Learning Lab (about the roles Medicaid, and the Children’s Health Insurance Program play in providing health coverage to children, pregnant women, and families)
The Georgetown University Center for Children and Families
  • Thursday, March 18, 1:00 ET
  • Thursday, April 15, 1:00 ET
  • Thursday, May 20, 1:00 ET
  • Thursday, June 17, 1:00 ET

Patient-Centered Outcomes Research Institute (PCORI)
The Arc
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Family Voices is a national organization and grassroots network of families and friends of children and youth with special health care needs and disabilities that promotes partnership with families--including those of cultural, linguistic and geographic diversity--in order to improve healthcare services and policies for children.