April 20 Update

In This Week’s Update:

  • New SHVS COVID-19 Resources
  • COVID-19 State Updates: CA, CT, DE, IL, IN, KY, MA, MD, MI, MN, MT, NC, NJ, NM, NY, OH, OR, PA, RI, VA, VT, WA & WI
  • Other State Updates: MN
  • Coordinating Care for Incarcerated During COVID-19
  • Supporting Out-of-Hospital Births to Protect Moms and Babies and Reduce Hospital Strain


New SHVS COVID-19 Resources

Last week, State Health & Value Strategies hosted a webinar, Implications of Health Care Provisions for States in the CARES Act, on the $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law on March 27. The webinar reviewed the health care-related provisions and federal funding in the CARES Act available to states as they respond to the COVID-19 outbreak. If you missed the webinar, the slides and a recording are posted to the SHVS website.

SHVS also launched an improved and updated version of its COVID-19 resource page. The update allows users to easily search information by keywords as well as to filter by topic, resource type, or source/publishing entity. The resource page will continue to serve as an accessible “one-stop” source of COVID-19 information for states as they work to make coverage and essential services available to all residents, especially high-risk and vulnerable people, during the COVID-19 pandemic. To that end, SHVS updated the expert perspective Grace Periods: A Good Start But Not Sufficient and published two new expert perspectives:


COVID-19 State Updates: CA, CT, DE, IL, IN, KY, MA, MD, MI, MN, MT, NC, NJ, NM, NY, OH, OR, PA, RI, VA, VT, WA, WI

  • Addressing Social Risk Factors
    • California – Governor Gavin Newsom announced several new initiatives to support Californians who have lost jobs or wages as a result of the COVID-19 pandemic, including launching a new call center to help assist residents with unemployment insurance applications and $75 million in statewide Disaster Relief Assistance funding to provide financial support for undocumented Californians affected by COVID-19.
    • Massachusetts – The Baker-Polito Administration launched a Spanish language online, mobile-friendly unemployment benefits application for those who need to apply.
    • New Jersey ­­– Governor Phil Murphy signed an executive order establishing a process to grant temporary reprieve to certain at-risk inmates during the public health emergency and requiring state IDs to be given out prior to an inmate’s release, along with a completed application for food stamps, Medicaid, welfare, or housing assistance.
  • Bulletins and Notices to Insurers
    • Vermont – Governor Phil Scott and the Department of Financial Regulation (DFR) announced an emergency regulation requiring commercial insurers to waive cost-sharing requirements, such as copayments, coinsurance, or deductible requirements, for the diagnosis and treatment of COVID-19. The emergency regulation is retroactive to March 13, 2020.
  • Consortiums to Reopen the Economy
    • Connecticut, Delaware, Massachusetts, New Jersey, New York,  Pennsylvania, and Rhode Island – The governors of these states announced the creation of a multi-state council to restore the economy and get people back to work. The coordinating group—comprised of one health expert, one economic development expert, and the respective chief of staff from each state—will work together to develop a fully integrated regional framework to gradually lift the states’ stay at home orders while minimizing the risk of increased spread of the virus.
    • Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin – The governors of these states announced  they will work in close coordination to reopen the economy in the Midwest region.
    • California, Oregon, and Washington – The governors of these states announced an agreement on a shared vision for reopening their economies and controlling COVID-19 into the future.
  • Section 1135 Waivers
    • Ohio – Governor Mike DeWine announced his administration is submitting a Section 1135 waiver to bolster telehealth services, remove staffing level requirements, ease restrictions on nursing home care, allow services to be furnished in alternative settings, and remove signature requirements for providers to ensure safe distancing without compromising access to care.
  • Special Enrollment Periods for Health Insurance
    • California – Covered California announced that 58,400 people had enrolled in health care coverage since the exchange announced a special-enrollment period in response to the COVID-19 pandemic.
    • Maryland – The Maryland Health Benefit Exchange announced that more than 21,500 residents have enrolled in coverage through the state’s health insurance marketplace, Maryland Health Connection. Earlier this month, the deadlines for both special enrollment periods (COVID-19 and the Maryland Easy Enrollment Health Insurance Program) were extended to accommodate growing health concerns as a result of COVID-19 and the new tax filing deadline.
    • Rhode Island – Rhode Island extended the SEP on HealthSource RI, its state-based marketplace, to allow for uninsured Rhode Islanders to purchase coverage through April 30, 2020.
    • Delaware, Illinois, Maine, Michigan, Montana, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Virginia, and Wisconsin – The governors from these states wrote HHS Secretary Alex Azar and CMS Administrator Seema Verma to ask the Administration to reconsider its decision and take swift action to allow for a special enrollment period of at least 30 days on the federal health care exchange.
  • Other
    • Massachusetts – The Baker-Polito Administration announced a new financial package of $800 million to support health care providers through the MassHealth program. This funding will support hospitals, nursing facilities, primary care providers, behavioral health providers, and long-term services and supports providers and will be distributed starting this month and through July.
    • Minnesota – In partnership with the University of Minnesota School of Public Health, the Minnesota Department of Health developed a Minnesota model to understand how the COVID-19 epidemic will play out in the state.
    • New Jersey – The governor signed legislation expanding protections of the Family Leave Act to allow employees forced to take time off to care for a family member during the COVID-19 outbreak with up to 12 weeks of unpaid family leave in a 24-month period without losing their jobs.


Other State Updates

  • Minnesota — Governor Tim Walz signed the Alec Smith Insulin Affordability Act to provide relief to Minnesotans struggling to afford their insulin. Under the legislation, eligible individuals in urgent need of insulin can go to their pharmacy once in a 12-month period and receive a one-time, 30-day supply of insulin for a $35 copay.


State and Federal Correctional Health Coordinators: Responding to the COVID-19 Pandemic

COVID-19 poses large and immediate health risks to people who are incarcerated, as well as correctional officers. While jails and prisons are often seen as parts of a single criminal justice system, in most states the criminal justice system is a patchwork of different agencies without a unifying authority to oversee and guide responses to health crises. To mount an effective response, Community Oriented Correctional Health Services (COCHS) proposes in a new paper that states should establish correctional health coordinators to coordinate the emergency response for incarcerated people. The paper outlines two approaches for states to establish and pay for a correctional health coordinator.


Supporting Out-of-Hospital Births to Protect Moms and Babies and Reduce Hospital Strain

The Urban Institute published a blog post on Urban Wire that reviews how policymakers can expand access to out-of-hospital birth options during the COVID-19 pandemic. Minimizing COVID-19 exposure for pregnant women and newborns is of particular concern given that the vast majority of births happen in hospitals. Also, in response to the pandemic, many hospitals are changing their labor and delivery policies to discharge women more quickly after delivery and to restrict partners, doulas, or other family members from being present during labor and delivery and after the birth. The blog post identifies several actions Medicaid programs can take to rapidly expand access to birth centers and home birthing options during the pandemic for women enrolled in Medicaid.