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Washington DC Update 11/3/21
We have a framework!

Last week the White House released the Build Back Better framework for reconciliation. Notably, the framework includes an invitation to share how the Build Back Better plan will affect CYSHCN and families. Take a look at it, and scroll to the bottom of that page for the opportunity to share your thoughts with the President!

A brief outline of what is included:

Universal Preschool for all 3- and 4-year-olds: Expand access to free high-quality preschool for more than 6 million children. This is a long-term program, with funding for six years.

Affordable High-Quality Child Care: Limit child care costs for families to no more than 7% of income, for families earning up to 250% of state median income. It enables states to expand access to about 20 million children. Parents must be working, seeking work, in training, or taking care of a serious health issue. This is a long-term program, with funding for six years.

Affordable, High-Quality Care for Hundreds of Thousands of Older Americans and People with Disabilities in Their Homes and Communities: Strengthening an existing program through Medicaid and ending the existing backlog and improving working conditions for home care workers.

Expanded Child Tax Credit: Extend for one year the current expanded Child Tax Credit for more than 35 million American households, with monthly payments for households earning up to $150,000 per year. Make refundability of the Child Tax Credit permanent.

Affordable Care Act Premium Tax Credits: Extend the expanded Affordable Care Act premium tax credits through 2025. Experts predict that more than 3 million people who would otherwise be uninsured will gain health insurance. Also, make Affordable Care Act premium tax credits available through 2025 to 4 million uninsured people in uncovered states.

A variety of Medicaid provisions such as permanent CHIP, Permanent Medicaid for Territories, extend post-partum coverage, etc. Read more on the Georgetown CCF blog: Big Strides for Coverage.

Medicaid Continuous Coverage Phased Out, but with Special Protections 
Build Back Better allows states to resume processing annual renewals and changes in circumstances under specific conditions starting in April 2022. Here is an outline of special rules guiding the phase out:

  • Phases out the increase in federal Medicaid funding starting in April 2022. To qualify for the extended increase in federal Medicaid funding, states must follow special enrollment rules that help protect consumers from inappropriate terminations of coverage.

  • Reinforces current CMS guidance requiring states to conduct a fresh review of eligibility based on current circumstances and to consider eligibility for all categories of Medicaid.

  • Promotes manageable workloads by limiting the number of renewals or redeterminations processed in a month.

  • Requires states to take action to update contact information and handle returned mail.

  • Collects key data to monitor the impact on enrollees.

For a detailed breakdown, read this Georgetown CCF blog post.

Next steps with Build Back Better? While the framework was laid out before Halloween, the next step is a VOTE on both reconciliation and the infrastructure bills. Expected to happen this week!
Presidential Proclamation: Family Caregiving
President Biden has issued a proclamation that November is National Family Caregivers Month.
5-11 Year Old COVID-19 Vaccination!
The CDC Advisory Committee recommended use of the Pfizer COVID-19 vaccine with children aged 5-11, and in the same day, CDC Director Walensky gave final approval.

States are rapidly preparing for the rollout of the vaccine for younger children, addressing both familiar and novel issues around equitable access, education, and partnerships. Check out this interactive webpage and report by NASHP highlighting state strategies to increase access to and uptake of the COVID-19 vaccine in children.
In Case You Missed It: Public Health Emergency (PHE) Renewed
On October 15, Health and Human Services Secretary Xavier Beccera renewed the COVID-19 public health emergency (PHE)The PHE was originally designated by Secretary Azar on January 31, 2020, and this marks the seventh renewal.

Even with an extension, there is no time like the present to prepare for PHE unwinding! State Health and Value Strategies (SHVS) developed this resource page to serve as an accessible one-stop source of information for states in “unwinding” after the end of the federal public health emergency (PHE).

This blog post, also on the SHVS website, is written by our friends at Manatt Health and speaks directly to concerns expressed about State Policy and IT System Strategies to Prepare for PHE Unwinding: Updating Medicaid Enrollee Address Information and Responding to Returned Mail that many F2Fs and families have expressed. Consider attending a Webinar on these strategies with presenters by the blog authors on November 10, 2021, 2-3 pm EST - learn more.
Sound the Alarm for Mental Health!
As reported last week, the Children’s Hospital Association (CHA), the American Academy of Pediatrics (AAP), and the American Academy of Child and Adolescent Psychiatry (AACAP) have recently declared a national state of emergency in child and adolescent mental health. In an effort to amplify the urgent need to address the emergency in kids’ mental health, CHA has launched a national initiative called “Sound the Alarm for Kids.” You can follow updates on the launch on Twitter at @soundalarm4kids. The initiative will run through 2021 and primarily focuses on urging Congress to enact legislation and increase funding to better support mental health for kids and teens.
Reports and Webinars of Interest
From the Center for Connected Health Policy. You can search by topic, state or federal. The report also has a helpful summary chart, and infographic.

Millions of Americans are eligible for health insurance plans with little or no premium and significantly reduced cost-sharing this coming open enrollment period, thanks to historically enhanced marketplace subsidies under the American Rescue Plan (ARP). This secret shopper study conducted during the recent COVID-19 special enrollment period suggests that some consumers shopping for comprehensive coverage during the upcoming open enrollment period will likely be directed instead to alternative plans without the protections of the Affordable Care Act (ACA).

Webinar: Veteran Medicaid Directors Discuss the Future of State Medicaid Program
Monday, November 8, 2021 | 2:00 pm ET | Register Here
Veteran Medicaid directors from Florida, South Dakota, and Idaho will share their thoughts on how Medicaid directors will likely approach such pressing issues as successfully emerging from the public health emergency; assessing opportunities afforded by President Biden’s Build Back Better plan; addressing looming challenges involving labor shortages, an impeding fiscal cliff, the future of pandemic-related regulatory flexibilities; and the growing role of home and community-based services (HCBS). Finally, they will share recommendations on how organizations can best maximize their effectiveness when meeting with state Medicaid directors by better understanding their world and what they need from various healthcare constituents like you. Hosted by Health Management Associates.

Thank you for subscribing to the Washington DC Update newsletter. Please feel free to contact the Family Voices Director of Public Policy and Advocacy, Cara Coleman, with any questions. Past issues of the Update appear on the Family Voices website. If you wish to unsubscribe, you can do so via the "Unsubscribe" link below.

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.