Universal Health Coverage Hearing Calls for more Attention to Social Determinants of Health

The House Ways and Means Committee held a hearing June 13 to discuss the increasingly popular call for universal Healthcare. Dr. Berwick, a witness at the hearing and the man responsible for implementation of ACA during the Obama administration, used his platform to call for an increased focus on social determinants of health, especially in rural areas. Berwick stated that providers must consider the nature of these at-risk communities, saying that the state of healthcare in the US right now is a “repair shop” but that we must invest upstream in social determinants such as housing. He suggested the implementation of a healthcare system that is sensitive to these issues and is capable of redistributing healthcare to causes of health, rather than simply treating the effects would be more effective.  While many supporters of Medicare for All considered the hearing a victory, others were quick to point out the unclear path ahead, and the absence of a hearing held by The House Energy and Commerce Committee.

Opioid Hearing Focuses on Wrap Around Treatment, Social Determinants of Health, and ACES

The House Oversight and Reform Committee held a hearing June 19 titled the “Inadequate Federal Approach to Opioid Treatment and the Need to Expand Care.” The hearing came as the Comprehensive CARE Act to Combat the Opioid and Substance Use Epidemic was reintroduced in the House and the Senate on May 8. Discussion centered around the need for more comprehensive treatment models for those suffering with addiction and for a ‘whole person’ approach, with one of the witnesses, Dr. Evans, CEO of the America Psychological Association pointing to the “behavioral, biological, and social underpinnings” of opioid addiction. Jean Ross, President of National Nurses United said that inequality and health inequity is the main driver of the epidemic. The conversation shifted to the generational effects of this epidemic when Angela Gray of Berkeley County Board of Health brought up Adverse Childhood Experiences and the role they are playing to perpetuate generations of addiction and substance use disorder. She reiterated the effect that addiction has on the family unit the population of grandparents raising grandchildren is rising. The CARE Act would allocate $100 billion to opioid treatment and prevention services over 10 years.

The Children’s Bureau Announces to Provide More State Flexibility on Family First

Earlier this month, the Children’s Bureau notified child welfare leaders of some flexibility and work-arounds given delays in the Family First Prevention Services Clearinghouse. A letter from Associate Commissioner Jerry Milner announced that the Children’s Bureau plans to issue some guidance to allow states to claim transitional payments for services under Title IV-E until the Clearinghouse can review and rate the program/service, if the state submits sufficient documentation. This guidance, expected in the next couple of weeks, will specify the types of documentation states will need to submit to demonstrate that the state conducted a through review that shows the program’s impact. The guidance will help with allowing for transitional payments, but eventually the Clearinghouse (when it’s up and running) will make determinations about whether a service is considered promising, supported, or well-supported. This concept of transitional payments is similar to a provision recently included in the Family First Transition and Support Act, cosponsored by Senators Sherrod Brown (D-Ohio) and Debbie Stabenow (D-Mich.), legislation that has been endorsed by the Alliance. The Family First Prevention Services Clearinghouse has yet to put out its initial list of approved services. Associate Commissioner Milner has stated previously that he intends to release that initial list in late spring and summer 2019.

In related news, 27 states have officially decided to delay implementation on Family First provisions, and other states are considering delaying, mostly because of the limits on congregate care required by FFPSA.

Source: The Chronicle of Social Change

30th Edition of KIDS COUNT Data Book Released

The Annie E. Casey Foundation recently released their 30th edition of the KIDS COUNT Data book. The data reports on how America’s child population and the American childhood experience has changed—and in some cases stayed the same—since 1990. The report shows that since 1990, America’s child population has increased by 10 million, but the childhood experience for youth around the country continues to vary greatly from region to region. Major findings include:

• The nation’s child poverty rate dropped from 22% to 18% in 2017, however, for African America and America Indian children the rate is significantly higher at 33%.
• In terms of health, the number of uninsured children increased for the first time since 2010 while the percentage of children without health insurance held steady at 5%.
• One in three kids across the nation are being raised by a single parent. On top of this, single-parent households are 4.5 times more likely than married households to live in poverty.
• More parents are financially stable, and more teens are graduating from high school and delaying parenthood.
• Access to children’s health insurance has increased compared to data from 2012.

Appropriations Update

Congressional leaders and White House officials met Wednesday to discuss budget caps and the debt ceiling and were unable to meet a compromise. We expect conversations to continue over the next few weeks. June 19, Congress passed a $1 trillion spending package (H.R. 2740) which includes funds for Labor-Health and Human Services-Education, Defense, State-Foreign Operations, and Energy and Water Development. This leaves one more bill up for passage in the next few weeks. The $320 billion spending package (H.R. 3055) includes funding for Agriculture-FDA, Commerce-Justice-Science, Interior-Environment, Military Construction-VA and Transportation-HUD. This package would also include a weekly compensation of $965 as a measure for federal contractors who lost work due to the partial government shutdown earlier this year.

Chairman Richard Neal (D-Mass.) Introduces Bill to Eliminate Tax on Non-Profit Parking, Expand Tax Credits for Families

The House Ways and Means Committee held a markup this week of the Economic Mobility Act of 2019 aimed at “putting hardworking Americans first and making it easier for families to afford childcare and other day-to-day necessities in an increasingly expensive world.” The markup passed the committee on a 22-19 vote and will next head to the full House of Representatives for consideration.

This legislation would repeal the Unrelated Business Income Tax (UBIT) on non-profit organizations. Many Alliance members have expressed concerns that they have been subject to taxes on parking and transit benefits for employees, as a result of the new tax law that passed last year.

Additionally, the legislation:

• Makes the Child Tax Credit (CTC) fully refundable for families who currently make too little to receive the entire credit, allowing all families to receive the full credit of $2,000 per child;
• Expands the Earned Income Tax Credit (EITC) for workers without children for the first time in 25 years, and includes the largest expansion of the EITC in more than a decade; and
• Increases funding for the Child Care and Development Fund (CCDF) meaningfully expands the child and dependent tax credit (CDCTC) for the first time since 2001, and expands dependent care flexible spending accounts (FSA).

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