These past few months have seen a buzz and conflicts over both the federal budget and the ongoing implementation of the Affordable Care Act, which marked its one year anniversary in March. Many of our sister organizations have worked to review, summarize and get information out on both the budget and ACA implementation. Two organizations that stay on top of these issues and provide a wealth of information for our members as well as assist us to advocate on behalf of Women, Children, and Families are the Association of Maternal and Child Health Programs [ http://www.amchp.org ]   and Families USA [ http://familiesusa.org/issues/childrens-health .]

AMCHP has created a National Center for Health Reform Implementation that serves as a central point of contact on all things health reform. The purpose of this center is to “provide state maternal and child health leaders and their partners with the information, tools and resources to optimize the opportunities presented by the ACA for improving services, systems, and health outcomes for MCH populations.”

In addition AMCHP, through its regular legislative updates, provides summaries of the budget passed in March, the HRSA spending plan, and what to watch for regarding the 2012 budget:

On March 7, the U.S. House of Representatives and Senate passed a final Continuing Resolution (HR 1473) to provide funding for federal government operations for the remainder of this fiscal year. The bill cut $38 billion from a range of federal programs, including significant cuts to the budget for HRSA and CDC. However, the bill includes funding levels that restore most of the MCH-related funding cuts from earlier proposals. The bill assumes $662 million for the Maternal Child Health block grant, the same as the FY10 level.

In March 2011, HRSA reported that the Title V Maternal and Child Health Services Block Grant has been restored to relatively flat funding of $656 million – a major victory in comparison to the Feb. 9 House of Representatives original proposal to cut $210 million. The final Title V allocation apparently reflects a small cut, less than 1 percent across the board applied to most programs. The HRSA plan also confirms funding of $299 million for Title X Family Planning Grants (a $17.4 million cut), $21.8 million and for Poison Control Centers (a $7.3 million cut) – also positive since both programs were zeroed out in earlier House proposals.  It makes no change to the mandatory $250 million FY 2011 allocation for the Maternal, Infant, and Early Childhood Home Visiting Program or other mandatory Affordable Care Act appropriations.  While this was relatively good news for MCH, there were disturbing cuts to critical HRSA programs:  $660 million cut to the base allocation for Community Health Centers (offset by the $1 billion increase in mandatory Affordable Care Act funds); $65 million cut to health professions; $47 million for rural health programs; $48 million for the Children’s Hospital Graduate Medical Education program; and a range of small cuts to many other programs.

Watching out for 2012 – ACT NOW - the U.S. House of Representatives is expected to next consider their FY 2012 Budget Resolution. This will provide a blueprint that sets in motion a process to once again propose perhaps even deeper cuts to discretionary health programs for FY 2012. Work on FY 2012 appropriations bills is expected to commence shortly, so in the coming days and weeks help to make the case for sustained and adequate MCH funding in next year’s budget. 

Medicaid and CHIP make up approximately 8 percent of federal spending, so we know these will be key budget lines which will come under scrutiny. As part of the 2012 budget ‘battle,’ Families USA reminds us of key messages in the debates around continuing funding for Medicaid and CHIP.

From Families USA - Messages for Decision Makers

Right now, all members of Congress are thinking about the budget and the debt ceiling vote. Even if you don’t have a particular proposal to talk about, it is important that you let your members know your position.

• Let them know that you realize that it is important to reduce the federal deficit over the long-term, and that includes controlling health care spending.
• The approach to deficit reduction should be sustainable, should balance spending reductions with revenue raising measures, and should not decimate programs that seniors and their families, people with disabilities, children and our most vulnerable citizens depend on.
• Medicaid and other low-income entitlement programs should be exempted from any mechanisms for automatic cuts, such as caps or triggers that set cuts in motion if targets are not met.
• Medicaid is an efficient program, with little fat to spare. It should be spared from cuts.
• Controlling health care spending should be part of a thoughtful deficit reduction process that focuses on better care delivery, not just making massive federal spending cuts and passing costs on to states and consumers. The Affordable Care Act established a framework for making lasting improvements in health care delivery by reining in spending and increasing coordination of care.

WHAT ARE WE DOING IN THE MCH SECTION?  Our goal is to assist our members to stay abreast of developments and provide tools for influencing policy members.  Timely communications mechanisms include our Facebook Page (APHA Maternal & Child Health Section Community) and our listserv through SLHINet. Make sure you sign into both of these (check our website for information on how to register) to get Section information as well as advocacy information.  You should also sign up for the APHA advocacy alerts which provide information on a wide range of public health issues as they need urgent attention during budget negotiations!  Go to http://www.apha.org/membergroups/sections/aphasections/mch/  for Section information or http://www.apha.org/advocacy/activities/  for APHA Advocacy activities.

Also don’t forget to register for the APHA Annual Meeting so we can see you all in November!!

Keep up all the good work for Women, Children, and Families!

Debra Jackson

Chair, MCH Section