AUGUST POLICY AND ADVOCACY WEBINAR

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1 AUGUST POLICY AND ADVOCACY WEBINAR The Latest Developments for Health Centers on the Hill: Challenges, Opportunities, Priorities, Asks, Messaging Wednesday, August 2, 2017 NACHC Policy & Advocacy Staff

2 Audio today will be provided via computer. Please double check that your speakers on your computer are working and/or plug in a headset to listen. You can adjust the volume of the audio on your computer or by using the Audio Broadcast control box.

3 This webinar is being recorded. You will be able to access the webinar recording on past_events The link to the recording will be distributed in the Washington Update

4 Questions? Use the chat box to ask your question at any point in the webinar. We want to see all of your questions! We ll try our best to respond to all of them.

5 In this briefing, we ll cover: Updates since our last webinar: what challenges and opportunities exist for health centers in the current debate? The Latest on the Hill: Primary Care Funding Cliff, Workforce, 340B, WHAT is going on in the Senate? Advocacy update: action items and the resources to help you complete them

6 Timeline What s happened and what s to come July 31-Aug. 31: House in Recess THCGME, NHSC Funding Expires July 28 th : Senate Vote FAILS on Skinny Repeal Aug 12-31: Senate in Recess August 27-29: NACHC CHI CHIP Funding Expires Debt Ceiling? CHC Fund Expires July August September Sept. 30 July 25 th : Senate Vote: Motion to Proceed Aug 13-19: Nat l Health Center Week??? Final Health Care Vote? End of Fiscal Year 2017 (CR, Omnibus or Shutdown) MIECHV, DSH, ~12 Other Extenders Expire FY18 Budget Deal?

7 AHCA in the Senate: Three Strikes and You re Out? 1. Repeal and Delay (without a replacement plan) Repeal key ACA provisions, goes into effect after 2 years; based on 2015 bill Failed (NO: all Ds, Alexander, Capito, Collins, Heller, McCain, Murkowski, Portman) 2. Better Care Reconciliation Act (BCRA) Repeal key ACA provisions, significant Medicaid changes, opioid funding, Cruz amendment Failed (NO: all Ds, Collins, Corker, Cotton, Graham, Heller, Lee, Moran, Murkowski, Paul) 3. Skinny Repeal Repeal individual & employer mandates, repeal Medical device tax, defund PP, expanded 1332 waivers, raised HSA limits Failed (NO: all Ds, McCain, Murkowski, Collins)

8 Where do we go from here? Return of Reconciliation? Bill is still alive though McConnell said it s time to move on Graham-Cassidy Bill? Replace federal money currently being spent on Medicaid expansion, tax credits, and cost-sharing reduction subsidies with a block grant to states to use as they see fit Time for a bipartisan effort? Immediate concerns (market stabilization), ACA fixes Problem Solvers Caucus, new proposals

9 Advocacy Tip: Do Your Homework! Did Your MOC vote in favor of repeal/replace Have your completed the Medicaid Impact Assessment & the Cliff Estimator Tool Leverage NHCW to deliver the HC message based on YOUR MOC. Is a THANK YOU appropriate? Educate, Connect Local Impact, Ask

10 Health Center Funding Discretionary/Appropriations Mandatory/Health Centers Fund/Cliff FY18 House LHHS Approps Bill: $157b bill passed Committee 7/19 Health Centers funded at $1.5b again $15m for new HRSA Oversight Office FY18 Approps Letters: Bilirakis-Green Letter 290 cosigners Wicker-Stabenow Letter 62 cosigners Our Ask: At least level funding, $1.5b, plus Cliff Fix is needed before 9/30 (60 days) CHC Fund Extension from MACRA expires 9/30 NHSC and THCGME (also CHIP, MIECHV, DSH, more) expire at the same time. Working on extenders package Goal is at least 5 years, lack of approps bills means short-term funding more likely.

11 Energy and Commerce Hearing on CHCs: Highlights Cook Area Health Services (CAHS) CEO and NACHC Board Treasurer Mike Holmes Testified 6/23 Only providers in most of the communities we serve. Primary care medical home for our nation s underserved communities & patients. Continue investments in the Health Centers program CHIP, NHSC, Health Center Workforce Development, 9/30 Cliff Energy and Commerce Committee Chairman Greg Walden (R-OR) Community Health Centers play a significant role in the nation s safety net for millions of individuals who may be medically underserved or face other barriers to care. Individuals and families served by these programs, are not just program enrollees, they are our neighbors, they are our friends.

12 Workforce Programs also Face Funding Cliffs National Health Service Corps (NHSC) Teaching Health Centers Graduate Medical Education (THCGME) Mandatory funding authorized in the ACA & extended for 2 years via MACRA ($310 million). Primary clinician recruitment & training tool for health centers (1/2 of all NHSC placements). Over 9,600 NHSC members caring for 10 million patients. Created in ACA to provide dedicated funding for community-based primary care residency training. 742 residency total slots in 27 states. Extended for 2 years via MACRA ($60 million). H.R Training the Next Generation of Primary Care Doctors (Rep. McMorris Rodgers)

13 Advocacy ACTION Step! Take action tell your Members of Congress to fix the cliff. , Tweet AND send a Facebook message Tools, resources, and materials CLIFF & MEDICAID IMPACT CALCULATORS at

14 Will They or Won t They: Congress, HHS and the CSRs If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon! What are CSRs or Cost-Sharing Reductions? ACA directed insurers to reduce cost-sharing for low income individuals ineligible for Medicaid in two ways: CSRs and premium assistance (tax credit) CSRs lower out-of-pocket costs, such as co-pays and deductibles, for enrollees in marketplace silver plans with incomes between 100% to 250% FPL HHS currently makes payments on a month-to-month basis, the total yearly cost for 2017 is $7B this funding reimburses insurers for offsetting cost-sharing amounts What to watch This week President Trump decision on whether to fund CSRs August 16 th deadline for insurers to adjust rates they ve already filed Without CSR payments, insurers may leave marketplaces or premiums by up to 20%

15 What Could a Bipartisan Market Stabilization look like? Problem Solvers Caucus = bipartisan group of 43 House Lawmakers Their solution: Provide mandatory funding for CSRs Create a federal stability fund for states to use to reduce premiums and other costs for individuals with expensive medical needs Change employer mandate to only apply to companies with more than 500 employees (compared with the current 50 employee threshold and define the full time workweek as 40 hours up from 30 hours) Repeal the ACAs 2.3% medical device tax Modify the ACA to make it easier for states to innovate and enter into compacts to sell coverage across state lines Other proposals floated/expected

16 The Latest on 340B E&C Subcommittee on Oversight & Investigations Hearing Witnesses from HRSA (OPA), GAO, HHS OIG Broad bipartisan support for health centers/ grantees Focus on lack of program transparency, need for better oversight, program integrity ie. Lack of reporting reqs, how savings are used, definition of patient Rising drug costs/ CMS proposed rule addressed multiple times CMS OPPS Proposed Rule Reduces how much 340B-eligible hospitals are reimbursed for drugs purchased under 340B Does not impact FQHCs, limited to Medicare reimbursement to hospital outpatient departments Only a proposal at this time, currently open for public comment

17 Advocacy Update What can you do today to make the case for health centers? hcadvocacy.org

18 Get ready for NHCW 2017! Celebrating America s Health Centers: The Key to Healthier Communities Visit the brand new NHCW site to post your events and find tons of tools, resources, and information!

19 Participate in National Health Center Week Plan a NHCW event post your events at Invite elected officials to your NHCW celebrations August means recess for Congress Don t forget to be persistent! Hcadvocacy.org

20 Check out the #NHCW17 Focus Days Sunday: Elected Officials Day Monday: Health Screenings Day Tuesday: Public Housing Health Centers Day Wednesday: Health Care for the Homeless Day Thursday: Farmworker Health Day Friday: Consumer Board Member Day Saturday: Children s Health Day Each day features: - Shareable social media posts - Blog post - Media templates - Event ideas - And more!

21 Engage the media Submit a letter to the editor or op-ed to your local media outlets We have templates for press releases, letters to the editor, and op-eds Think outside the box newspaper, TV, radio, and online

22 Get online during National Health Center Week Share pictures of your events Retweet other health center advocates posts Take & share video Use focus day images Tag your elected officials make sure they see what an important part of the community your health center is #NHCW17 #ValueCHCs

23 Keep up the momentum Thank you s Always say THANK YOU to attendees, sponsors, the media, etc. Let your supporters participants AND nonparticipants know how your event turned out Contests! Picture and video contests are open through August! Engage your community through the voting process Rules and info at healthcenterweek.org/2017-picturevideo-contests/

24 What can individuals do? Ask your friends, family, and colleagues to take action. They can show their support by: 1. Signing up as an advocate 2. Recruiting 10 advocates 3. Sharing their story - #ValueCHCs Hcadvocacy.org

25 Resources for advocates New website mobile friendly with all the resources you need Easy to recruit advocates via and social media with the click of a button View recordings of previous webinars Talking points PPS fact sheet Medicaid savings study Funding cliff and Medicaid impact estimators Links to take action and spread the word P&I Policy Papers HCADVOCACY.ORG/MAKETHECASE Didn t find what you need? federalaffairs@nachc.org or grassroots@nachc.org.

26 Save the date If you missed the NHCW kick-off webinar on May 10, or any past Monthly Policy & Advocacy Webinars, you ll find them at Wednesday, September 13 at 3:30PM ET: September Policy & Advocacy Update Webinar

27 Questions?

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