1. Health Reform Highlights for Children with Special Health Care Needs May 19, 2010

2. Who is AMCHP? The Association of Maternal & Child Health Programs is a national resource, partner and advocate for state public health leaders and others working to improve the health of women, children, youth and families, including those with special health care needs. 2 May 19, 2010

3. AMCHP Center for Health Reform Implementation Immediate Opportunities Intermediate Reforms and Insurance Expansions Long Term – Role of Title V in a Reformed System 3 MARCH 13, 2009 LOREM IPSUM DOLOR

4. Health Reform Highlights for MCH Big Picture Patient Protection and Affordable Care Act became law March 23, 2010. Coverage for 32 million uninsured people. Broad reforms in insurance industry practices. Major new investments in health care access and care coordination through medical homes. 4 MARCH 13, 2009 LOREM IPSUM DOLOR

5. Health Reform Highlights for MCH Expands Medicaid to all under 133% of poverty Preserves Medicaid & CHIP coverage for children above 133% of FPL. Extends Early, Periodic, Screening, Diagnosis, and Treatment (EPSDT) to all children gaining coverage via Medicaid Assures continuation of CHIP benefits package to eligible children until 2019. 5 MARCH 13, 2009 LOREM IPSUM DOLOR Coverage and Benefits Basics

6. Health Reform Highlights for MCH Coverage and Benefits Basics Creates state-based Exchanges to provide coverage and provides tax credits to help people with income up to 400% of FPL Establishment of temporary high-risk pools until state exchanges are up and running Establishes four benefit packages available within Exchanges - bronze, silver, gold, and platinum will vary by actuarial value. The bronze plan provides minimum essential coverage at actuarial value of 60%; platinum at 90%. 6 MARCH 13, 2009 LOREM IPSUM DOLOR

7. Health Reform Highlights for MCH Exchange Plan Benefits Must Include Ambulatory services Emergency services Hospitalization Maternity & newborn care Mental health & substance abuse disorder services, including behavioral health treatment Prescription drugs 7 MARCH 13, 2009 LOREM IPSUM DOLOR Rehabilitative & habilitative services and devices,. Laboratory services, Preventive & wellness services and chronic disease management, and Pediatric services, including oral and vision care. Eliminates co-pays for preventive services.

8. Health Reform Highlights for MCH Insurance Market Reforms Young adults can remain on their parents’ health plan until age 26 Children with insurance can no longer be denied coverage for pre-existing conditions Insurance plans can no long impose lifetime caps or restrictive annual limits 8 MARCH 13, 2009 LOREM IPSUM DOLOR

9. Health Reform Highlights for MCH Access and Care Coordination through Medical Home Investment Health Homes in Medicaid: $25 million in planning grants to states to develop a state plan amendment to provide health homes. CMS Center for Medicare and Medicaid Innovation: establishes a new Center for Medicare and Medicaid Innovation within CMS to test innovative payment and service delivery models for Medicare, Medicaid, and CHIP programs. Includes mandatory appropriation of $10 billion over the next ten years for implementation. 9 MARCH 13, 2009 LOREM IPSUM DOLOR

10. Health Reform Highlights for MCH Access and Care Coordination through Medical Home Investment Pediatric Accountable Care Organization Demonstration Project: authorizes participating states to recognize pediatric medical providers as an accountable care organization (ACO) for purposes of receiving incentive payments State Grants to Promote Community Health Teams that support the Patient-Centered Medical Home: grants for community-based interdisciplinary teams which will provide support services to primary care practices. 10 MARCH 13, 2009 LOREM IPSUM DOLOR

11. Healthy Children. Healthy Families. Healthy Communities. WWW.AMCHP.ORG Michelle Alletto, MPA Associate Director Public Policy & Government Affairs malletto@amchp.org (202) 266-3045