In This Week’s Update:
- New State Plan Option Extends Postpartum Medicaid Coverage to 12 Months
- Millions of Medicaid Enrollees May Transfer Health Coverage—How States Can Prepare
- The Bridge Between Medicaid and the Marketplace—What Role Might MCOs Play in Unwinding the PHE?
- North Carolina’s COVID-19 Support Services Program: Lessons for Health Policy Programs to Address Social Needs
- California’s Marketplace Tries New Tactics to Reduce the Number of Uninsured and Underinsured
- Still Time to Apply: State Medicaid Churn Learning Collaborative Opportunity
New State Plan Extends Postpartum Medicaid Coverage to 12 Months
The American Rescue Plan Act’s (ARPA) new state plan option which offers state Medicaid and CHIP agencies an opportunity to provide 12 months of continuous postpartum coverage launched last week. Louisiana, the first state CMS is approving to take advantage of this new opportunity under the ARPA, began offering its enhanced coverage to an estimated 14,000 pregnant and postpartum people. North Carolina also announced that Medicaid postpartum healthcare coverage will be extended from 60 days to 12 months for eligible people, and CMS noted that it is working with an additional nine states to extend postpartum coverage. For more information on the ARPA state option to extend postpartum coverage, see this SHVS issue brief.
Millions of Medicaid Enrollees May Transfer Health Coverage—How States Can Prepare
State Health and Value Strategies (SHVS) published two new resources for states to support their planning for unwinding the continuous coverage requirement following the end of the PHE. A new issue brief, The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare, identifies several areas in which state departments of insurance may want to coordinate with other agencies or external stakeholders, issue new regulations or guidance, and establish means for minimizing gaps in coverage or access to services as an estimated 4.8 million former Medicaid enrollees transition to coverage through the marketplaces. And a new expert perspective Public Health Emergency (PHE) Unwinding Reporting Requirements: Considerations for States summarizes the new reporting requirements released by CMS on March 22. The piece presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.
The Bridge Between Medicaid and the Marketplace—What Role Might MCOs Play in Unwinding the PHE?
Following the end of the PHE, and the continuous coverage requirement, as those no longer eligible for Medicaid transition to the Marketplace, the role of managed care organizations (MCOs) may be important, particularly plans that participate in both markets in the same geography, sometimes referred to as “overlap plans.” Katherine Hempstead of the Robert Wood Johnson Foundation explores this issue for the Marketplace Pulse series, which includes an updated map that illustrates the prevalence of overlap by MCO since 2020. Overlap between Medicaid and the Marketplace has grown over the past several years. The resurgence in Marketplace participation was driven by Medicaid MCOs. During that time, the share of counties with at least one overlap plan increased from 59% to 67%. For some plans, most notably Centene, there is a high degree of overlap between their Medicaid and Marketplace participation, while for others like Anthem and United Health Group there is far less.
North Carolina’s COVID-19 Support Services Program: Lessons for Health Policy Programs to Address Social Needs
The North Carolina Department of Health and Human Services launched its COVID-19 Support Services Program in August 2020 to address multiple pandemic-related social needs in counties with COVID-19 hot spots in four target regions of the state. A new issue brief co-published by the Milbank Memorial Fund and the Duke Margolis Center for Health Policy highlights lessons learned from the COVID-19 Support Services Program. To study the COVID-19 Support Services Program, the authors of the brief interviewed its administrators and frontline providers across the program’s service regions and partnered with one of the program’s largest grantee organizations to analyze survey data. The analysis offers key recommendations to health policymakers creating or administering health policy programs to address social needs in local populations.
California’s Marketplace Tries New Tactics to Reduce the Number of Uninsured and Underinsured
Although many individuals are eligible for marketplace subsidies under the Affordable Care Act (ACA), costs associated with health insurance, lack of awareness, and administrative enrollment barriers have hindered coverage take-up. Additionally, some consumers who sign up for marketplace coverage wind up in plans with high out-of-pocket costs, leaving them underinsured with limited access to care. A recent blog by the Commonwealth Fund highlights California’s new marketplace strategies to reduce the number of uninsured and underinsured individuals. California recently adopted strategies for its state-run marketplace to decrease friction in the enrollment process and help current marketplace enrollees move into plans with lower cost sharing. For example, in order to prevent coverage gaps for people transitioning from Medicaid to Marketplace coverage at the end of the COVID-19 Public Health Emergency, California will soon partially automate marketplace enrollment for people losing Medicaid coverage by placing those who are eligible into the lowest-cost silver plan available.
Still Time to Apply: State Medicaid Churn Learning Collaborative Opportunity
The Benefits Data Trust Medicaid Churn Learning Collaborative will help states navigate the end of the Public Health Emergency for their Medicaid members. Benefits Data Trust, with support from the Robert Wood Johnson Foundation is currently accepting state applicants to join a new 12-month learning collaborative that will provide a unique opportunity for state Medicaid agencies to receive individually tailored technical assistance to develop and advance policies and practices that reduce Medicaid churn – the cycling of individuals on and off Medicaid. The technical assistance provided through this opportunity — at no cost to states — will support states in preparing for the end of the COVID-19 federal public health emergency and the subsequent termination of the Medicaid continuous coverage requirement. To learn more, visit the FAQ page and complete an interest form HERE by April 15, 2022.
- Louisiana – Louisiana Medicaid has launched a phone campaign to encourage its members to update their contact information. Automated calls will go out to members reminding them to update their phone number, mailing address and email address.
- Minnesota – The Minnesota Department of Human Services announced the release of a new HIV Prevention, Care and Anti-Stigma social media toolkit. The campaign is a collaboration between community organizations, advocates, the Minnesota Department of Health and the Minnesota Department of Human Services. The campaign and its graphic elements are a reminder that HIV-related stigma is one of the biggest barriers to getting tested and treated.
- North Carolina – The North Carolina Department of Health and Human Services announced a major milestone in its innovative Healthy Opportunities Pilot program, with 10 people who are members of managed care successfully receiving a food service delivered through NC Medicaid Managed Care. The Healthy Opportunities program tests evidence-based, non-medical interventions, which are designed to improve the health of Medicaid enrollees while reducing costs.
- New Jersey – The Murphy Administration released a detailed description of its plan to improve healthcare affordability in New Jersey through a recently-launched program aimed at addressing rising healthcare costs. The Health Care Affordability, Responsibility and Transparency (HART) Program lays out the target rate of growth for healthcare spending and explains the program’s comprehensive approach to understanding the factors that drive costs.
- New York
- CMS granted approval of the state’s Medicaid Section 1115 waiver renewal for five years through March 31, 2027. CMS extended the current waiver and approved an amendment to permit dual eligibles who enroll in a Medicare Dual Eligible Special Needs Plan to stay enrolled in a mainstream Medicaid managed care plan under certain criteria.
- Governor Kathy Hochul announced up to $50 million in available funding for school districts to improve student access to mental health resources and assist students who have experienced trauma that has impacted their education. A Request for Proposals has been issued by the New York State Office of Mental Health, who will administer the program.
- Nevada – Governor Steve Sisolak announced the appointment of the state’s first Public Health Resource Officer, Allison Genco. Senate Bill 424, sponsored by Governor Sisolak during the 2021 Session of the Nevada Legislature, created a Public Health Resource Office that is charged with analyzing the existing public health infrastructure of the state and making recommendations related to unmet needs, opportunities for federal and private grant funding, and improved coordination between providers of public health services.
- Oklahoma – The Oklahoma Health Care Authority (OHCA) announced an outreach campaign asking all SoonerCare (Oklahoma Medicaid) members to update their contact information and documentation. This will help the agency better understand which members will be eligible to renew their benefits at the end of the PHE.
- South Carolina – The South Carolina Department of Health and Human Services announced on March 29, 2022, that postpartum Medicaid coverage will be extended from 60 days to 12 months, effective April 22, 2022.
- Washington – The Washington Health Benefit Exchange, the state-based marketplace, posted a draft of their 1332 waiver application seeking public comment. If approved, the waiver will provide access to federally non-subsidized health and dental coverage through Washington Healthplanfinder, the state’s online insurance marketplace, to all Washington residents, regardless of immigration status, starting in plan year 2024.