April 5 Update

In This Week’s Update:

  • ARPA Funding for HCBS
  • HHS Measures to Encourage Vaccinations
  • Special Enrollment Period
  • COVID-19 State Updates: MA, MN, NE, NJ, NY, OR, WA, WI
  • Other State Updates: AL, AZ, DE, NE, NJ, OR, VA
  • Connecting Patients with Social Services
  • Reducing Disparities in COVID-19 Vaccinations
  • Health Equity Toolkit for Decisionmakers


 ARPA Funding for HCBS

Last week State Health and Value Strategies published a new issue brief on the enhanced federal funding for state Medicaid spending on home- and community-based services (HCBS) included in the American Rescue Plan Act (ARPA). States are now eligible to receive a 10 percentage point increase in their federal medical assistance percentage (FMAP) for specified HCBS through March 31, 2022. The new issue brief describes the HCBS FMAP increase provision, the requirements for states receiving the enhanced federal funding, and considerations and next steps for state policymakers.


HHS Measures to Encourage Vaccinations

Last week the Department of Health and Human Services (HHS) announced additional measures to encourage vaccinations and increase vaccine confidence as part of the next phase of its COVID-19 public education campaign. The administration is launching the COVID-19 Community Corps—a nationwide, grassroots network of local voices people know and trust to encourage Americans to get vaccinated. As part of this community-driven strategy, HHS is also unveiling new social media profile frames so Americans can display their choice to get vaccinated and encourage their friends and family to do the same. And the first TV ads, including in Spanish, will start running nationwide today to encourage Americans to get vaccinated as soon as they are eligible.


Special Enrollment Period

Last week HHS Secretary Xavier Becerra announced an additional $50 million in support of advertising the special enrollment period (SEP) for healthcare.gov and the availability of additional subsidies as a result of the ARPA. The Biden administration also announced it is extending the deadline for the federal SEP until Aug. 15.


COVID-19 State Updates: MA, MN, NE, NJ, NY, OR, WA, WI

  • Massachusetts – The Baker-Polito Administration announced details for a new mobile vaccination effort made possible by a recently launched partnership with the Federal Emergency Management Agency that is bringing 6,000 additional daily doses to Massachusetts. The administration also announced the awarding of a $4.7 million grant to support local public health efforts in the 20 communities in the Commonwealth most disproportionately impacted by COVID-19, and highlighted new outreach efforts in these communities.
  • Minnesota – Gov. Tim Walz signed legislation into law that increases the reimbursement rate for administering the COVID-19 vaccine to the Medicare rate.
  • Nebraska – The Department of Health and Human Services issued a provider bulletin to inform providers about updated rates for COVID-19 vaccine administration and to update Federally Qualified Health Center and Rural Health Clinic providers on the procedure for billing for COVID-19 vaccine administration.
  • Washington – The state released new findings that reveal just how successful a partnership between Serve Washington, the state’s AmeriCorps service commission, the Washington State Department of Agriculture, and the Schultz Family Foundation was to help make the AmeriCorps program more accessible to its members and, in turn, help address food insecurity for Washington families during the COVID-19 pandemic. Since November 2020, AmeriCorps members in the Washington COVID-19 Response Corps collectively provided more than 23.8 million pounds of food to Washingtonians and served them more than 4.7 million meals.
  • Wisconsin – The Wisconsin Department of Health Services announced $6.2 million in grants has been awarded to one hundred organizations to promote health equity across the state. The investment aims to increase vaccinations by supporting organizations to serve as trusted messengers within their communities, build vaccine confidence, and reduce barriers that hinder vaccine access for communities that have been disproportionately affected by COVID-19.
  • New Jersey and Washington – These states extended their SEPs until the end of the year and Aug. 15, respectively.
  • New York and Oregon – These states are reminding residents of the availability of more affordable health insurance plans as part of the American Rescue Plan and announced new tools and communications to help residents take advantage of savings. NY State of Health system changes were made starting March 31 and consumers will receive a notice and email from NY State of Health no later than April 5 letting them know the increase in the amount of tax credits they will receive, and the action needed to claim them. The Oregon Health Insurance Marketplace announced their tool, available at www.OregonHealthCare.gov/WindowShop, has been updated to correctly calculate additional savings now available to people shopping through the marketplace as a result of the American Rescue Plan.


Other State Updates: AL, AZ, DE, NE, NJ, OR, VA

  • Alabama – The Alabama Department of Public Health (ADPH) is seeking a local lead agency to develop a coalition or engage a current coalition to promote health system changes to address tobacco prevention and cessation within the Black community. The selected local lead agency will collaborate with ADPH to develop a five-year strategic plan to improve health equity among this population.
  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) is seeking waiver and expenditure authority from the Centers for Medicare and Medicaid Services (CMS) on two waiver demonstration projects. The AHCCCS Housing and Health Opportunities demonstration seeks to enhance and expand housing services and interventions for AHCCCS members who are homeless or at risk of becoming homeless. The Targeted Investments Program 2.0 waiver demonstration request will continue the Targeted Investments Program through 2026 and will sustain the integration efforts of current participants and expand integration opportunities to new providers. AHCCCS is accepting public comments through May 3, 2021.
  • Delaware – Department of Health and Social Services Secretary Molly Magarik presented the state’s first Benchmark Trend Report, which summarizes the health care spending and quality data collected for calendar year 2019. The first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8 percent, with the target expected to decrease gradually to 3 percent over the following three years. For 2019, the report found overall health care spending in Delaware totaled $8.2 billion vs. $7.6 billion for 2018. The per-capita cost increased from $7,814 in 2018 to $8,424 in 2019, or 7.8 percent—more than twice as high as the 3.8 percent target. 
  • Nebraska – The Department of Health and Human Services officially submitted a Medicaid state plan amendment request to CMS to offer medication-assisted treatment to treat opioid use disorders.
  • New Jersey
    • Gov. Phil Murphy highlighted a $20 million investment in the Fiscal Year (FY) 2022 budget proposal for Phase 1 of the Cover All Kids campaign. This initiative will improve accessibility and remove barriers to cover nearly 90,000 uninsured children in the state. The first phase will remove barriers and support connections to coverage for nearly 53,000 children through FY 2022 by 1) eliminating the 90-day waiting period for coverage to children newly enrolling into the Children Health’s Insurance Program (CHIP), 2) removing premiums families would pay for their children enrolled in CHIP, and 3) developing targeted outreach efforts to boost enrollment for currently eligible children who are unenrolled.
    • The Department of Banking and Insurance published a report of a study conducted by Oliver Wyman focused on New Jersey’s provision of additional financial relief for consumers through state‐sponsored premium subsidies that are in addition to and coordinate with the premium and cost‐sharing subsidies currently provided under the Affordable Care Act.
  • Oregon – The Oregon Health Authority, along with the Oregon Health Leadership Council, announced that 40 organizations have signed a compact to adopt “value-based payments” which reward health care quality rather than health care quantity. This initiative extends the quality improvement and cost-growth containment goals established through Oregon’s coordinated care model from public programs to the private sector. The agreement targets moving to 70 percent of payments following advanced value-based payment methods over five years and supports the work of the cost growth target program, which is beginning implementation this year.
  • Virginia – Gov. Ralph Northam signed legislation authorizing the development of the Commonwealth Health Reinsurance Program. The bill requires the Secretary of Health and Human Resources to convene a work group to develop recommendations for developing a state-based subsidy program to increase affordability of health plans to individuals and to increase enrollment in the Virginia Health Benefit Exchange.


Connecting Patients with Relevant Social Services

Social Interventions Research and Evaluation Network (SIREN) at UCSF is launching a new cycle of six biweekly conversations on topics related to providing “Assistance,” health care sector activities that reduce social risk by connecting patients with relevant social services. The SIREN Coffee & Science events are organized around the National Academies of Sciences, Engineering, and Medicine’s “Five As Framework” and are conversations between experts in social interventions research, practice, and policy. This next series will be broadcast live, with conversations every other Friday starting at 9:30 a.m. PST starting April 9. You can also listen to the conversations on demand at any time by subscribing to the podcast. The first cycle of conversations are available on the SIREN website.    


Practices from States to Reduce Racial and Ethnic Disparities in COVID-19 Vaccinations

As vaccine availability increases and eligibility expands to meet the goal of vaccinating as many individuals as quickly as possible, prioritizing equity along with speed will be essential to ensuring access to, and uptake of, COVID-19 vaccines across all populations. A new brief published by the Duke Margolis Center for Health Policy and the National Governors Association highlights state-level strategies that aim to improve reporting of race and ethnicity data in vaccine distribution, use data to plan for allocation and distribution according to need, overcome systemic inequities that lead to differential access to COVID-19 vaccinations, and build trust in COVID-19 vaccines and COVID-19 vaccination processes. Governors may consider these strategies as ways to increase equity as they expand eligibility for COVID-19 vaccinations to all population groups. 


Health Equity Toolkit for Decisionmakers

The National Partnership for Women & Families released a series of new tools titled Choosing Health Equity: Understanding Decision Points in Policy / Practice / Research. The resources/tools are designed to support health care stakeholders in examining the ways in which structural racism manifests in health care policy and practice. The tools include questions and actions to consider and are designed to surface the numerous decision points that exist in the cycle of health care policy and practice—to disrupt standard processes in order to achieve a healthier, equitable, and just society. By posing concrete questions to consider, and providing recommendations and resources for stakeholders to apply, the tools are intended to support policymakers as they evaluate programs and policies to advance health equity.