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July 2011


Federal Funding and Budget Update

Work on appropriations for FY12 has ground to a halt, as Congress and President Obama try to find agreement on legislation to raise the nation’s debt ceiling. At press time, various proposals were being discussed, with the sticking points being the level of spending cuts and the inclusion of revenue raisers.  At press time, the House Labor, Health and Human Services, Education Appropriations subcommittee was scheduled to mark up a bill funding programs for FY12 on July 26. This deadline may slip into September, after the scheduled August recess.

Health Reform Implementation

The NACCHO Health Reform Workgroup completed work on a white paper describing challenges and opportunities faced by LHDs by the implementation of the Affordable Care Act. The white paper is available on the NACCHO Health Reform webpage in addition to a new, extensive resources page. The resources can also be printed out or forwarded as a PDF.

The Patient Protection and Affordable Care Act (ACA) requires the secretary of Health and Human Services to ensure that any federally conducted or supported health care or public health program, activity, or survey collects and reports data, to the extent practicable, on race, ethnicity, sex, primary language and disability status, as well as other demographic data on health disparities as deemed appropriate by the Secretary. The U.S. Department of Health and Human Services (HHS) announced new draft standards for comment on collecting and reporting data to help researchers, policymakers, health providers, and advocates identify and address health disparities impacting these communities. Comments on the draft standards are due Aug. 1.

On July 11, HHS announced proposed regulations governing the establishment of health insurance exchanges. Comments are due Sept. 28.

The rule provides three options for states:  their exchanges can be ready by the January 2013 deadline; they can get a conditional approval for their exchanges; or they can initially let the federal government run the exchange. HHS says that states would have to notify HHS before “significant” changes are made in an exchange plan and the plan would have to get written approval before it could proceed with those changes.

The separate proposed regulation that deals with lessening the impact on insurers of covering high-risk patients includes the following: a risk-adjustment formula that would pay insurers higher rates for sicker patients; a three-year reinsurance program that would set up a non-profit that would pass through temporary payments for insurers that cover patients with high medical claims, and a risk corridor program that would operate through 2016. That would give more federal funding to insurers whose claims are at least 3 percent higher than projected, while giving fewer federal dollars to insurers whose costs are at least 3 percent less than projected.

On July 14, HHS announced 278 awardees of $95 million in school-based health center grants for construction or renovation. These funds were made available through the Affordable Care Act. 

NACCHO Policy Compendium

NACCHO has developed a compendium of policy recommendations from all its current policy statements, categorized by topic. This information is available for LHDs as a template for policy actions with local or state policymakers.  The compendium will also be shared with national partners including the National Association of Counties, the U.S. Conference of Mayors, and the National Association of Local Boards of Health.