Well, Arizona’s legislative session ended last week, so you’re spared my impossibly long policy updates. You can visit this PowerPoint to dive into the good things, bad things, and the missed opportunities this year. It’s still a draft summary of the Session because the Governor hasn’t taken action on several bills (voluntary certification of community health workers, public health measures in schools, dental therapy, food truck licensing, and fresh produce in SNAP). BTW- Let me know if you see anything I've left out of the draft powerpoint so I can update it before my Webinar next week
I’ll be doing a Webinar about the legislative session on Thursday May 17 at noon in conjunction with the UA Center for Rural Health & the UA Telemedicine Program. Visit the AZ Telemedicine Program’s Website to register.
FDA Finally Implementing ACA’s Menu Labeling Requirement
You might have noticed that more and more restaurants and fast food places are starting to put calorie and other nutrition information on their menus. That’s not a coincidence or accident- they’re implementing the menu nutrition labeling requirements in the Affordable Care Act. Section 4205 of the ACA requires restaurants with 20 or more locations to post calorie content information for standard menu items directly on the menu and menu boards. Vending machine operators with 20 or more machines are also required to disclose calorie content for certain items.
Nutrition clarity is a real opportunity for public health change. Not only will the new labels give the public key information to help them make better decisions about what they buy for themselves and their families- it’ll give pause to restaurants before they label their menus- giving them an opportunity to change ingredients to lower calorie counts. It may even spur a trend away from super-sizes and toward more appropriate and reasonable serving sizes. With 32% of the calories consumed in the US tied to eating outside the home- this is an important opportunity.
Anyway, the FDA announced this week that they’re finally implementing the requirements that were established by the ACA. Another evidence-based policy intervention brought to you by the Affordable Care Act.
CMS Denies Kansas’ Request for 3-year Lifetime Medicaid Eligibility
This week the Centers for Medicare and Medicaid Services Administrator denied Kansas’ request to impose a 3-year lifetime limits on Medicaid eligibility.
Her decision bodes well for us in Arizona- at least when it comes to lifetime coverage limits (although CMS is poised to almost certainly approve AZ’s work/work training request). Arizona law requires AHCCCS to annually ask CMS for permission to require work (or work training) and income reporting for “able bodied adults” and a 5-year lifetime limit on AHCCCS eligibility (with some exceptions).
A few months ago AHCCCS turned in their official waiver request asking permission to implement those requirements. The AHCCCS Director recently postponed the negotiation process of the lifetime limit request to expedite approval of the work requirements. See his letter here. Word on the street is that AHCCCS expects approval of the work requirements in June.
Mid-year Federal Budget Cut Request
This week the White House submitted a special message to Congress requesting they rescind $15B bill in budget authority from the current fiscal year. The proposal includes unobligated balances from prior-year appropriations and reductions to budget authority for mandatory programs.
Below are selected programs proposed for rescission by the Administration that may impact public health programs. For more information, view the entire rescission proposal here.
Children’s Health Insurance Fund: The proposal would rescind $5B in amounts made available by the Medicare Access and CHIP Reauthorization Act of 2015 to supplement the 2017 national allotments to states, including $3B in unobligated balances available on October 1, 2017.
Child Enrollment Contingency Fund: The proposal would rescind $2B in amounts available for the CHIP Contingency Fund, of which there were $2.4B available. The Contingency Fund provides payments to states that experience funding shortfalls due to higher than expected enrollment.
Centers for Medicare and Medicaid Innovation (Innovation Center): The proposal would rescind $800M in amounts made available for FY11-19 for the Innovation Center, of which there were $3.5B available on October 2017. The Innovation Center was created to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and CHIP while preserving or enhancing quality care.
Speak for Health: Fund Public Health in 2019
As Congress begins its work on the FY 2019 appropriations process, Speak for Health and tell our members of Congress to reject the proposed cuts to important public health programs in the president's budget proposal and instead to prioritize public health by building upon the important increased investments in public health provided by Congress in FY 2018.
Most of you know Dr. Bob England, who's been on the AZ public health scene for the last 30 years including 12 years as the Director of the Maricopa County Public Health Department. You know that he's a terrific cartoonist. But did you know he's an engaging travel writer?
Bob's been living for the last couple of months just outside of London. He's been writing some terrifically entertaining travelogues- with a splash of public health of course. Take a few minutes when you're on a comfortable couch and enjoy Travelogue 1 & 2: Getting Settled. Here’s Travelogue 3: Nutrition. Enjoy.
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