1. Hawaii: Updates * Outreach and Enrollment Campaign Report Now Available: Hawaii Covering Kids recently conducted a successful mass marketing campaign targeting eligible but unenrolled children ages 0 through 18 years old in low- and middle-income households. * Another Multilingual Radio and Television Campaign is underway! Thirty-second advertisements about children's health insurance are airing in 17 languages on KNDI, KIPO, KZOO, KREA, KPHI, KIKU, and KBFD. Photos and updates are posted on the Hawaii Covering Kids Facebook page. * Ready to Learn is distributing Hawaii Covering Kids flyers in 8,000 school supply packets for low-income children and youths. * Hawaii Covering Kids is sponsoring a community forum about the new health care reform law on August 26. Target audiences are advocates and policy leaders and the featured speakers are Edwin Park (Center on Budget and Policy Priorities) and Jennifer Sullivan (Families USA). 2. Michigan: Television Station Helps Uninsured Kids and Wins National Award WWMT Newschannel 3 was honored with the National Association of Broadcasters (NAB): Service to Children Television Award. This is one of three national television awards that the NAB presents each year to a television station for an outstanding community outreach program. Vice President and General Manager Jim Lutton received the "Service to Children Award" in a Washington D.C. ceremony. The station won this award for "Caring for Kids," an all-day phone-a-thon that encouraged parents to call in and sign up their children into low-cost state health insurance programs that are under utilized. Programs like MI-Child and Healthy Kids provide medical, dental and vision coverage to eligible children. "We are proud of the outstanding work done by our reporters, anchors and producers in telling stories that motivated parents to pick up a phone and call to register their children and to the partnerships we created throughout Western Michigan that made this possible," said Lutton. WWMT joined forces with various print organizations and electronic media as well as public and private medical services to promote this one-day event. Hundreds of volunteers helped answer phones and process paperwork for families who make too much to qualify for Medicaid but not enough to afford private health insurance. These volunteers and officials helped streamline the application process and got West Michigan children the health care they need much sooner then they would have on their own. The one-day phone-a-thon helped process paperwork for over 600 West Michigan uninsured children to get medical care. [The Daily Reporter, 06/28/10] 3. National: Patients' Bill of Rights Long Time in the Making On Tuesday, I sat in the East Room of the White House and listened to the President as he announced the release of a set of rules implementing provisions of the Affordable Care Act that will help protect consumers from some of the worst insurance industry abuses. I couldn't help but think back ten years ago, when I was a staffer in the U.S. Senate, working on Patients' Bill of Rights legislation. At the time, I met with many patients and families from around the country who'd suffered from decisions by their health plan to deny or limit needed care and to limit their choice of doctors. Many of these families had children with special health care needs and were facing terrible decisions about what tests, surgeries, and drugs they could afford because their health plan was not providing the coverage they needed. That was ten years ago. While the bill never garnered the votes it needed for passage, the difficulties those families faced never went away. Thousands of children continue to be denied coverage because of a pre-existing medical condition. Families that dutifully pay their premiums are abruptly dropped from their policies after filing a claim-and told it's because they didn't fill out their application correctly. And countless children with high cost medical conditions are hitting their plans' annual and lifetime limits on coverage, leaving families to forgo needed treatment or face medical bankruptcy. On Tuesday, as I listened to the President describe the health insurance reforms that will be effective in September of this year in this latest round of rulemaking, I realized-it took ten long years, but we finally passed that Patients' Bill of Rights. It was one of the happiest moments of my life. So what does this rule do? First, it says that health insurance companies can no longer deny or limit coverage for children who have a pre-existing medical condition. This provision is estimated to help up to 162,000 children gain access to coverage they don't currently have. This provision applies to all plans except individual policies that are grandfathered (i.e., those that were in existence prior to the law's enactment and have not made significant changes since). For families that are in grandfathered plans, they may need to change their policy in order to get the necessary coverage for their child. Second, it stops health insurance companies from setting lifetime limits on coverage, and restricts the amount of annual limits on essential benefits. The ban on lifetime limits applies to all plans, while the restrictions on annual limits apply to all plans except those individual policies that are grandfathered. The restrictions on annual limits are adjusted over time-in the first year the limits can be up to $750,000, in the second year up to $1.25 million, and in the third year up to $2 million. Starting in 2014, all annual limits on coverage of essential benefits are banned. U.S. Department of Health & Human Services (HHS) is charged with defining what constitutes the essential benefits package, which will determine what items and services would be covered under the annual limits restrictions. However, HHS has not yet issued those regulations and families will temporarily need to rely on plans' "good faith" definitions of what constitutes essential benefits. Third, it stops health insurance companies from retroactively canceling a policy because of an unintentional mistake on an application. This is a particularly nasty industry practice that leaves people stranded just when they need coverage the most. This rule applies to all plans, including those that are grandfathered. Fourth, it makes clear that health plan enrollees have the freedom to choose any available participating primary care provider in their plan's network, including any available participating pediatrician for their children. It also prohibits companies from requiring a referral to see an OB/GYN. This applies to all plans except those that are grandfathered. Lastly, it prohibits all plans except those that are grandfathered from charging higher cost-sharing for patients who need to use an out-of-network emergency room. And it sets some requirements for how plans reimburse out-of-network providers to help protect patients from potential "balance billing." These new rules, which will go into effect starting September 23, 2010, will provide critical relief and peace of mind to thousands of families who count on their health insurance to be more than an empty promise. It was a long time in the making, but we finally did it. [Sabrina Corlette, Say Ahhh! Blog, 06/25/10]