The U.S. Department of Health & Human Services (HHS) and the Departments of Labor and the Treasury (Departments) proposed a rule to strengthen access to birth control coverage under the Affordable Care Act (ACA).  Under the ACA, most plans are required to offer coverage of birth control with no out-of-pocket cost.  To date, millions of women have benefited from this coverage. Today’s rule proposes to expand and strengthen access to this coverage so that all women who need or want birth control are able to obtain it. The action is the latest effort by the Biden-Harris Administration to bolster access to birth control at no cost.

The ACA and its implementing regulations guarantee coverage of women’s preventive services, including birth control and contraceptive counseling, at no cost for women who are enrolled in group health plans or individual health insurance coverage.

The proposed rules are part of the Biden-Harris Administration’s commitment to ensuring access to reproductive health care and follows earlier action to expand access to birth control and family planning services. HHS, the Department of Labor, and the Department of the Treasury previously convened a meeting with health insurers and called on the industry to commit to meeting their obligations to provide contraceptive coverage as required by the ACA. The Departments also issued guidance to clarify protections for birth control coverage under the ACA following multiple states’ efforts to restrict access to contraception in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. HHS also announced nearly $3 million in new funding to bolster training and technical assistance for the nationwide network of Title X family planning providers.

• To review or comment on the proposed rules during its 60-day public comment period, visit the Federal Register.
• For more information on the proposed rules, consult the fact sheet available at https://www.cms.gov/newsroom/fact-sheets/coverage-certain-preventive-services-under-affordable-care-act-proposed-rules.
• In addition, HHS also recently released a report entitled: “Marking the 50th Anniversary of Roe: Biden-Harris Administration Efforts to Protect Reproductive Health Care,” which outlines the actions HHS has taken in the face of the health crisis precipitated by the Dobbs decision.

The full report can be read at https://www.hhs.gov/sites/default/files/roe-report.pdf – PDF.

From the Pennsylvania Department of Human Services (DHS)

Starting in March, recipients of Supplemental Nutrition Assistance Program (SNAP) benefits will no longer receive the Emergency Allotment (EA) additional payments created during the COVID-19 public health emergency and will resume receiving one SNAP payment per month.

These additional SNAP payments have been crucial for people over the past three years during the COVID-19 pandemic. Ongoing economic uncertainty and high food prices are contributing to food insecurity for many Pennsylvanians, and we expect the impact of the end of SNAP EA payments to be significant.

Additionally, the 2023 cost-of-living adjustment (COLA) for Social Security and Social Security Income (SSI), which is also set by the federal government, prompted an 8.7 percent increase to Social Security payments. SNAP eligibility thresholds — also set at the federal level — did not rise proportionally. Because of this, approximately 249,000 households will experience a decrease in their base SNAP benefits by an average of $40 per household, which will take effect in March when EAs end. The Department of Human Services (DHS) anticipates approximately 5,000 to 20,000 households will be disenrolled from SNAP due to the Social Security increase. These federal changes will primarily affect older Pennsylvanians and seniors.

Help is available for any individuals or families through Pennsylvania’s charitable food partners. Anyone who can donate food or resources is encouraged to help your local food banks and food pantries as they prepare to meet this potential additional need.

What are SNAP Emergency Allotments?

With funds made available due to the federal COVID-19 emergency, DHS began providing EAs as a second monthly payment to SNAP recipient households that were receiving benefits since March 2020. The EAs increased the SNAP budget amount to the maximum available amount for their household size or, since early 2021, were a minimum of $95. These payments were distributed separate from the initial payment as an extra payment each month.

Why are the extra payments ending?

The EAs are ending due to passage of the recent federal legislation. February will be the last month EAs are sent, and SNAP recipients will only receive one regular SNAP payment starting in March. This change will happen for all SNAP recipients, and SNAP households will receive letters via mail about the change in SNAP payments.

Update your personal information

Updating your personal information will help ensure households are receiving the maximum SNAP benefit based off their individual circumstances. Changes to household size, income, or expenses can be reported:

• Online at dhs.pa.gov/COMPASS
• Via the myCOMPASS PA mobile app
• By calling DHS’ Customer Service Center at 877-395-8930
  (or 215-560-7226 for Philadelphia residents)

Resources for SNAP Recipients

DHS recognizes the impact these changes may have on households and wants to make sure families that need food assistance know where to go for help:

For Pregnant Women and Families

• Pennsylvania Special Supplemental Nutrition Program for Women, Infants and Children (WIC) — SNAP recipients who are pregnant or have kids under 5 may be able to get help buying food from PA WIC. You can call 1-800-WIC-WINS or apply online.

For Older Pennsylvanians

• If you are a SNAP eligible senior citizen, apply to receive additional vouchers redeemable at more than 800 farm stands and more than 200 farmers’ markets in Pennsylvania. The Senior Food Box Program can also provide you with additional shelf-stable groceries. Learn more about these programs from the Pennsylvania Department of Agriculture.

Additional Food Resources

• PA 211 — Connect with various local food resources through the United Way of Pennsylvania by calling 211 or visiting www.pa211.org.
• Feeding PA — Find local food banks and other food assistance programs.
• Ending Hunger and Food Security in Pennsylvania — Visit these sites from DHS and the PA Department of Agriculture for information on assistance programs and other resources.

How Can Pennsylvanians Help?

Support Your Local Food Network

Acting Secretary Valerie Arkoosh recently encouraged Pennsylvanians who are able to support their local food banks and pantries. Pennsylvania’s food network works tirelessly every day to be a resource and safety net for their communities. Small donations can grow into a big difference, so please do what you can so they can continue their life-saving work.

Help Spread the Word

DHS has developed a communications toolkit designed to help organizations, advocacy groups, government agencies, and others spread awareness about the changes to federal laws that will end the SNAP Emergency Allotment payments. Materials include newsletter text, social media posts, print documents, and more. Please use these materials to help educate and inform your audience about the upcoming changes.

In the first year of the COVID-19 pandemic, the federal government provided an extra 6.2 percentage points in their Medicaid funding to states in exchange for allowing continuous enrollment – that is, pausing annual review of eligibility – for most Medicaid beneficiaries for as long as the official Public Health Emergency (PHE) declaration remained in place.  Since that change, enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) has grown by almost 30 percent and, as of September 2022, nearly 91 million individuals were enrolled across the programs.

After several extensions, the PHE is set to expire in mid-April; however, new legislation calls for continuous enrollment and other pandemic-related flexibilities to end on March 31, 2023. Beginning on April 1, states claiming the temporary increase will be able to end Medicaid or CHIP enrollment for individuals, following a review of their eligibility. As explained in a letter to State Health Officials, states may begin disenrollment as early as February 1, 2023.  Once the process begins in each state, they will have 12 months to “unwind” expanded eligibility and return to their normal enrollment process.

Eligibility and renewal systems, staffing capacity, and investment in end-of-PHE preparedness vary across states. Because of the volume of new beneficiaries, federal health officials anticipate loss of coverage for millions of individuals and families.

To smooth the transition, the Centers for Medicare & Medicaid Services (CMS) is working with states to help them:

1. Prepare for the renewal process and educate Medicaid/CHIP enrollees about the upcoming changes, and
2. Ensure beneficiaries take the necessary steps to renew coverage, or transition to other coverage if they’re no longer eligible.

In its Communications Toolkit for Continuous Enrollment Unwinding, CMS identifies health care providers and clinics, local health departments, community-based organizations, and even schools and places of worship as effective avenues for outreach.

The Federal Office of Rural Health Policy will continue to monitor what’s happening, translate the unwinding process and its effects for rural stakeholders, and keep you up to date on significant news and deadlines.

Helpful Links

U.S. Department of Health & Human Services – Projected Enrollment Effects and Policy Approaches

Centers for Medicare & Medicaid Services – guidance, official documents, and communications toolkits in seven languages and Engaging Managed Care Plans to Maximize Continuity of Coverage

Federal Communications Commission – Action to Ensure Americans Receive Critical Information on Health Care Coverage

Georgetown Health Policy Institute – 50 State Unwinding Tracker

Kaiser Family Foundation – 10 Things to Know about the Unwinding of the Medicaid Continuous Enrollment Provision

Getting the Grant: Successfully Applying for ARC Funding Opportunities is an in-person workshop series designed to help prospective applicants submit strong applications for POWER, INSPIRE, and ARISE funding in 2023.

ARC is traveling to three Appalachian subregions to help more potential applicants meet with our grant staff, ask questions, and hear helpful tips for securing funding:

• February 23, 2023: Southern Appalachia Pre-Application Workshop (Belden, MS)
• February 28, 2023: Central Appalachia Pre-Application Workshop (Knoxville, TN)
• March 2, 2023: Northern Appalachia Pre-Application Workshop (Pittsburgh, PA)

Click here to register.

The Pennsylvania Department of Health and the Bureau of EMS has appointed Dr. Daniel Bledsoe as the next State EMS Medical Director to serve the Bureau of EMS in consulting and advising on matters related to EMS, effective January 30, 2023.

Dr. Bledsoe has been a member of the EMS community since 1989, after joining his local fire department while in high school. Dr. Bledsoe currently serves as the EMS Medical Director for UPMC in the Central Pennsylvania Region with oversight of several agencies including Lancaster EMS, UPMC Community LifeTeam EMS, and a regional online medical control facility serving six counties.

Dr. Bledsoe served as the charter medical director of the UPMC West Shore Hospital Emergency Department and maintains clinical privileges at several UPMC hospitals in Central Pennsylvania. In his role as an EMS physician, Dr. Bledsoe continues to actively participate in field operations and has served as the interim chief of two hospital-based EMS services during times of transition. While attending West Virginia University for his undergraduate degree and Marshall University for his medical degree, Dr. Bledsoe has severed as an Emergency Medical Technician and instructor with Jan-Care Ambulance, Monongalia County EMS, and Marshall University EMS. Continuing to support EMS education, Dr. Bledsoe has served as the program medical director for Harrisburg Area Community College and currently serves as the medical director for the Pennsylvania College of Health Sciences Paramedic Program.

Dr. Bledsoe holds board certification in Emergency Medicine and Emergency Medical Services through the American Board of Emergency Medicine. In addition to his various clinical roles, Dr. Bledsoe is a proud member of Pennsylvania Task Force One Urban Search and Rescue (USAR), which is one of just 28 national Federal Emergency Management Agency (FEMA) USAR teams in the country. With Task Force One, Dr. Bledsoe serves as a Medical Team Manager and has deployed to disasters such as Hurricane Katrina and the Surfside Collapse. Dr. Bledsoe also serves as a researcher on matters related to EMS and has served as a site principal investigator and coordinator for the RAMPART trial which included York Area EMS agencies, including the leading site for enrollment within the Commonwealth of Pennsylvania (White Rose Ambulance).

Dr. Bledsoe is a resident of York County where he lives with his wife Allison and four children.

The Office of the Chief Statistician is taking a key step forward in its formal process to revise OMB’s statistical standards for collecting and reporting race and ethnicity data across Federal agencies (Directive No. 15) by publishing an initial set of recommended revisions proposed by an Interagency Technical Working Group.

This process commenced last summer with the goal of ensuring that the standards better reflect the diversity of the American people. Comprising Federal government career staff who represent more than 20 agencies, the Working Group was charged with proposing recommendations for improving the quality and usefulness of Federal race and ethnicity data. Today we are announcing those initial proposals, which include:

• Collecting race and ethnicity together with a single question;
• Adding a response category for Middle Eastern and North African, separate and distinct from the “White” category; and
• Updating SPD 15’s terminology, definitions, and question wording.

It’s important to remember that the recommendations are preliminary—not final—and they do not represent the positions of OMB or the agencies participating on the Working Group.

As we consider these recommendations, we want to hear directly from the American people. Input from non-governmental stakeholders and the public will help guide the Working Group as it continues to refine and finalize its recommendations. We encourage everyone to provide your personal thoughts and reactions on these proposals, including how you believe they may affect different communities, by April 12, 2023.

You can visit the Working Group’s new website, read the full Federal Register Notice, provide feedback on the Working Group’s initial proposals, and participate in one of the Working Group’s virtual, bi-monthly listening sessions or upcoming public virtual town halls to share your individual perspectives directly. You can provide as little or as much feedback as you’d like for the Federal Register Notice (e.g., just addressing one question posed or responding to all aspects). To schedule a listening session to offer your perspective, please send a brief email expressing interest to Statistical_Directives@omb.eop.gov.  Additional details on the virtual town halls will be shared on the Working Group’s website. In all of our efforts to gather your valuable feedback, we will not be seeking consensus recommendations.

We are committed to a full, transparent revision process, guided by input from the American people. Your participation in this process will play a critical role in helping us improve the way Federal agencies safely and accurately collect and use information on the race and ethnicity of our diverse America. This is vital to ensure our programs and policies are effective across the Federal government—and we look forward to sharing additional updates in the months ahead. We are on track to reach the goal of completing these important revisions by the Summer of 2024.

The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority. The Centers for Medicare & Medicaid Services has many resources to help you and people with Medicare understand how and when changes will happen as a result of the new prescription drug law.

Materials for People with Medicare

Help get information into the hands of beneficiaries who need it. Check out these resources on Medicare.gov.

• 7 Things to Know About Medicare Insulin Costs
• Saving money with the Inflation Reduction Act
• Information about Insulin Costs and Coverage

Want to know more?

We’ve also got resources to help those who assist people with Medicare understand which elements of the prescription drug law are already in effect and when others will be implemented.

• Frequently Asked Questions About Medicare Insulin Cost-Sharing Changes in the Prescription Drug Law
• Timeline of the Drug Price Negotiation Program implementation process
• CMS New Prescription Drug Law Implementation Timeline
• Additional Resources

Key dates for drug price negotiation implementation include:

• By September 1, 2023, CMS will publish the first 10 Medicare Part D drugs selected for the Medicare Drug Price Negotiation Program.
• The negotiated maximum fair prices for these drugs will be announced by September 1, 2024 and prices will be in effect starting January 1, 2026.

In future years, CMS will select for negotiation 15 more Part D drugs for 2027, 15 more Part B or Part D drugs for 2028, and 20 more Part B or Part D drugs for each year after that, as outlined in the Inflation Reduction Act.