April 8 Update

In This Week’s Update:

  • Eligibility & Enrollment final rule webinar
  • Short-Term Limited Duration Insurance Final Rule
  • The Debate About Banning Menthol Cigarettes
  • Lessons Learned from Research on Unwinding
  • State Medicaid Member Experience Qualitative Data Scan
  • State updates: AZ, CA, CO, FL, ID, MA, MN, MO, NC, NE, NM, NV, NY & PA

Eligibility & Enrollment Final Rule Webinar 
On Thursday, April 11 at 12:30 p.m. ET, State Health and Value Strategies (SHVS) will host a webinar which will review key Medicaid and CHIP provisions in the Medicaid Eligibility and Enrollment final rule and discuss considerations for state policymakers as they prepare to build upon their current platforms and planning processes to comply with the rule. Please be sure to register for the webinar (which is required) and feel free to share the registration information with other interested state colleagues.

 

Short-Term Limited Duration Insurance Final Rule
Last week, SHVS published an expert perspective that examines the components of the Short-Term, Limited Duration Insurance (STLDI) final rule. The expert perspective discusses the implications of the rule for state regulators, including the revised definition of STLDI and consumer notice requirements. Also last week, the final Notice of Benefit and Payment Parameters for 2025 was published. Experts are reviewing the final rule and SHVS will have a summary of the considerations for states next week.

 

PODCAST: The Debate About Banning Menthol Cigarettes
The latest episode of  the Princeton Pulse dives into the ongoing debate about banning menthol cigarettes in the United States. Menthol cigarettes are more addictive and ultimately more harmful than tobacco-flavored cigarettes, yet they are still around, attracting young smokers, increasing health disparities, and causing preventable deaths. The FDA has proposed a policy to prohibit their sale; however, the policy is stalled under the influence of a presidential election year and lobbying by Big Tobacco. For this episode, Heather is joined by Keith Wailoo, a professor of history and public affairs at Princeton and author of “Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette”; and Carol McGruder, founding member and co-chair of the African American Tobacco Control Leadership Council.

 

Lessons Learned from Research on Unwinding
The Medicaid and CHIP Payment and Access Commission (MACPAC) April 2024 public meeting will be webcast live on April 11 and 12. As part of Friday’s meeting events, MACPAC is hosting a panel featuring SHVS Deputy Director Dan Meuse, who, along with other panelists, will be discussing what research can tell us about unwinding. The special panel will be webcast at 10:15 a.m. EST and will also include Genevieve Kenney, Vice President and Senior Fellow at the Urban Institute and Jennifer Tolbert, Deputy Director at the Kaiser Family Foundation Program on Medicaid and Uninsured. Register to attend the meeting (the agenda is available here) and listen into the special panel.

State Medicaid Member Experience Qualitative Data Scan
The State Health Access Data Assistance Center (SHADAC), with support from the Robert Wood Johnson Foundation, finished the first phase of SHADAC’s Medicaid Health Equity Monitoring Tool project with the creation of a high-level conceptual wireframe of a potential tool. Phase two requires identifying opportunities and gaps in populating the wireframe and SHADAC has created a resource focused on qualitative research studies related to Medicaid member experience. Findings show that there are few qualitative sources available that explore the experiences of Medicaid enrollees, and even fewer that focus specifically on 15 populations of interest, which include people of color, non-English speaking populations, and persons living with disabilities. Of the 21 studies reviewed, only two surveys were longitudinal, representing a substantial gap in the availability of sustained qualitative data collection on the Medicaid member experience.

 

State updates: AZ, CA, CO, FL, ID, MA, MN, MO, NC, NE, NM, NV, NY & PA

  • Arizona – The Arizona Health Care Cost Containment System sent letters encouraging 1,926 parents of children who had been discontinued from KidsCare, the state’s CHIP program, to re-apply. As many as 3,000 children who were previously ineligible may now be eligible due to an increase in the upper income limit of the program.
  • California – New data from the Department of Health Care Services shows that more counties are implementing Enhanced Care Management (ECM) and Community Supports for eligible enrollees as part of the state’s Medi-Cal transformation. ECM and Community Supports address both medical and social factors that can impact a person’s health, and include housing assistance, medically tailored meals to support short-term recovery, homemakers, and personal services.
  • Colorado – Connect for Health Colorado, the state’s official health insurance Marketplace, released its annual open enrollment report, detailing how federal and state laws and the statewide network of certified experts contributed to nearly 250,000 Coloradans signing up for a health insurance plan by the end of open enrollment. The report also includes charts and interactive county maps showing enrollment, plan prices, and financial help by county.
  • Florida – Florida submitted a request for a new CHIP section 1115(a) demonstration entitled, “Florida Children’s Health Insurance Program Eligibility Extension.” This demonstration aims to increase access to CHIP by raising the income eligibility threshold from 200% to 300% of the federal poverty level.
  • Idaho – CMS approved an amendment to the section 1115 demonstration, “Idaho Behavioral Health Transformation.” This amendment will allow Idaho to continue the COVID-19 public health emergency flexibility to reimburse legally responsible individuals (LRIs) for providing personal care services, typically provided by direct care workers in the home. Under this amendment, LRIs must meet certain provider requirements set by the state and all other criteria established by the demonstration to receive payments for providing direct care.
  • Massachusetts – The Healey-Driscoll administration has awarded $2.9 million to 20 organizations led by Black, Indigenous and people of color (BIPOC) to address substance-use in the communities they serve. The grants are awarded through the Redefining Community Wellness program, a new initiative intended to support BIPOC-led organizations committed to addressing substance-use disorder, including by focusing on underlying social, economic, and environmental conditions that can put people at greater risk for substance-misuse.
  • Minnesota – The Minnesota Department of Health released new data detailing health insurance coverage in the state during 2023. The data is from the Minnesota Health Access Survey, a biennial state-based population survey that collects information on Minnesotans’ health insurance coverage and healthcare access. The percent of Minnesotans without insurance fell to 3.8% in 2023, an all-time low for the 22-year survey.
  • Missouri – The Missouri Department of Social Services MO HealthNet Division announced CMS’ approval of a 1915(b) waiver amendment allowing for the full deployment of the Transformation of Rural Community Health (ToRCH) pilot project. ToRCH will address critical social care challenges that compromise individuals’ ability to maintain their health and effectively manage chronic conditions.
  • Nebraska
    • The Nebraska Department of Health and Human Services (DHHS) launched an Accommodation Services questionnaire website for Nebraskans who require accommodation while seeking DHHS services. This questionnaire will provide referrals to DHHS divisions that can best meet the clients’ most critical and urgent needs.
    • The DHHS Division of Medicaid & Long-Term Care will host a Medicaid Listening Tour throughout April and May titled “Medicaid Insights: Navigating Changes and Progress in 2024.” The tour will consist of 13 meetings in 11 cities along with two virtual sessions and will share information regarding unwinding as well as current projects focused on improving the program.
  • Nevada – Nevada Health Link, the state’s official health insurance Marketplace, announced the successful integration of Artificial Intelligence (AI) into its Marketplace platform. Nevada is the first Marketplace to receive CMS approval for the use of AI-based interactive virtual agents to enhance the customer service experience. This AI-driven tool offers callers natural language interactions that answer common questions and requests instantaneously, augmenting the call center’s normal business hours by operating round-the-clock support to individuals seeking help with basic needs such as password resets and finding enrollment assistance.
  • New Mexico – The New Mexico Human Services Department announced the open enrollment period for Medicaid under the new Turquoise Care program, from April 1, through May 31, 2024. This introduces expanded managed care organization (MCO) options, allowing current MCO enrollees to choose a health plan tailored to their needs.
  • New York – The New York State Department of Health and NY State of Health announced the expansion of the state’s Essential Plan public health insurance program took effect on April 1. The program now includes residents with incomes up to 250% of the federal poverty level, including the Deferred Action for Childhood Arrival population.
  • North Carolina
    • Governor Cooper announced that more than 400,000 North Carolinians now have access to healthcare through the state’s Medicaid expansion. This number represents more than two-thirds of the 600,000 people North Carolina expects to enroll over the next two years. Since December 1, the state has enrolled an average of more than 1,000 people per day in Medicaid expansion.
    • The North Carolina Department of Health and Human Services is celebrating two years of the Healthy Opportunities Pilots and announced the intent to expand these services statewide. The Healthy Opportunities Pilots addresses people’s social needs with services like food, housing, transportation, and services related to interpersonal violence and toxic stress. Preliminary research also shows a significant savings in medical costs to the state from Healthy Opportunities Pilots participants.
  • Pennsylvania – Governor Josh Shapiro announced the Pennsylvania Insurance Department will issue guidance to insurers to provide coverage for over-the-counter (OTC) contraceptives with or without a prescription. With the launch of the first FDA-approved OTC daily oral contraceptive pill, Opill, Pennsylvania insurers are encouraged to cover OTC contraceptives and are being asked to exempt this medication from the lengthy drug exceptions process as a best practice.