August 19 Update

In This Week’s Update:

  • Final Public Charge Rule Released
  • State Updates: DE, LA, MN, NJ, NY, OR, & TX
  • Webinar: Strategies to Reduce Health Disparities
  • Webinar: Final Public Charge Rule Implications
  • Trends in Employer-Sponsored Insurance
  • State Opportunities to Support Family Caregivers
  • Effects of Medicaid Expansion under ACA


Final Public Charge Rule Released

Last week, the Department of Homeland Security (DHS) issued a final version of its public charge rule. The rules goes into effect on October 15 and will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The rule broadens the programs that the federal government will consider in public charge determinations to include previously excluded health, nutrition, and housing programs, and outlines the factors the federal government will consider in making a public charge consideration. On September 3 at 1:00 p.m. ET, State Health and Value Strategies is hosting a webinar that will analyze the rule and potential implications for Medicaid and other health-related public benefits.


State Updates: DE, LA, MN, NJ, NY, OR, & TX

  • Delaware – The Delaware Division of Public Health (DPH) released the Drug Overdose Mortality Surveillance Report. Using the integration of 12 multi-agency datasets, the report provides a demographic picture of the Delawareans who died from drug overdoses in 2017, describes key statewide efforts to address the drug overdose and substance use crisis, and identifies opportunities for engagement.
  • Louisiana
    • The Louisiana Departments of Health and Corrections are welcoming public comment on the Louisiana Hepatitis C Elimination Plan. The plan seeks to guide efforts to achieve elimination of the virus as a public health threat in Louisiana by the end of 2024. Comments are due by September 24.
    • The Louisiana Department of Health selected two hospitals to participate in the Department’s Neonatal Opioid Withdrawal Syndrome Pilot Project. During this two-year pilot project, improvement teams from the two hospitals will work closely with the Department’s Louisiana Perinatal Quality Collaborative to improve the identification and treatment of pregnant women with opioid use disorders and improve the care of infants with neonatal opioid withdrawal syndrome. 
  • Minnesota – The Minnesota Department of Human Services announced that it received federal approval to roll out a new package of services designed to help seniors and people with disabilities — including those struggling with mental illnesses and substance use disorders — to find and maintain their own housing, and avoid costly institutional care. The new support services will start in July 2020 and will be paid as a new benefit under the state Medicaid program.
  • New Jersey – Governor Phil Murphy signed into law a bill which requires certain public facilities and offices to provide on-site lactation rooms. Additionally, the legislation requires the New Jersey Department of Health to provide information about lactation room availability and the New Jersey Department of Education to provide information on lactation policies in schools.
  • New York – The New York State Department of Health announced that it is submitting for public comment an application to the Centers for Medicaid and Medicare Services, to provide Medicaid services to certain incarcerated individuals about to be released from county jails and New York State prisons. The services will be provided beginning 30 days prior to the release date for people enrolled in Medicaid with certain serious health conditions. The Waiver Amendment is posted online for public comment for 30 days beginning August 14.  
  • Oregon – The Oregon Health Insurance Marketplace granted more than $800,000 in funding to nine community groups and 33 insurance agencies for outreach and enrollment activities. The awardees will use the grants to publicize the upcoming health insurance open enrollment period, and to help Oregonians enroll in coverage through and other programs.
  • Texas –  The Texas Department of Health and Human Services announced its efforts to work toward better health for mothers and babies by addressing disparities, highlighting Texas WIC’s breastfeeding support program, and providing information and breastfeeding help to families at events throughout the state this month.


Evidence-based Strategies for Reducing Health Disparities

State Health and Value Strategies is convening the third webinar in its series SHVS Health Equity Through Managed Care on Tuesday, August 27 from 2:30-3:30 ET. The upcoming webinar, Evidence-Based Strategies for Reducing Health Disparities, will identify evidence-based interventions that states can use to address disparities in their Medicaid managed care programs. During the webinar, Dr. Marshall Chin, Co-Director of Advancing Health Equity: Leading Care, Payment and Systems Transformation at the University of Chicago, will provide an overview of approaches for reducing disparities, drawing from a review of over 400 disparity intervention studies and from his program’s experience providing technical assistance to health care organizations. The webinar will also provide a roadmap to guide the work of Medicaid managed care programs to reduce disparities in care and elucidate the role of consumers in those interventions.

Registration (required) at the following link:


Final Public Charge Rule: Analysis and Potential Implications

SHVS will host a webinar on the final public charge rule, facilitated by experts at Manatt Health, on Tuesday, September 3 from 1:00-2:00 p.m. ET. Released on August 12 by the Department of Homeland Security (DHS), the rule will go in effect beginning October 15 and will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar will review the final rule, highlight changes from the proposed rule, and explore the rule’s potential impacts on consumers, states and providers. Speakers will highlight the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits.

Registration (required) at the following link: 


Trends in Employer-Sponsored Health Insurance 2014-2018

Using data from the Medical Expenditure Panel Survey-Insurance Component, a new analysis from the State Health Access Data Assistance Center highlights the experiences of private sector workers with employer-sponsored insurance (ESI) from 2014 through 2018 at the national level and within the states. The analysis includes a report narrative highlighting key findings on the levels of and trends in average ESI premium and deductibles as well as employee access to and take up of ESI coverage. Other resources include individual state profiles, 50-state comparison data tables and an interactive map.


State Opportunities to Support Family Caregivers

Family caregivers represent an overlooked — but vital — source of care and support for older adults. Approximately 34 million Americans provide unpaid care to an adult aged 50 and older. As part of its Helping States Support Families Caring for an Aging America initiative with six states, the Center for Health Care Strategies (CHCS) published a fact sheet and companion infographic that sheds light on how vital family caregivers are to the U.S. health care workforce and economy, and outlines examples of how some states are developing initiatives to better support these individuals. CHCS will continue to distill lessons from the states’ efforts and shared information broadly with stakeholders across the country.


The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

The Kaiser Family Foundation published an issue brief summarizing findings from 324 studies of the impact of state Medicaid expansions under the ACA. The brief covers those studies published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and updates earlier versions of the brief with studies through June 2019. More recent studies continue to support earlier findings but provide additional findings in key areas, including expansion’s effects on health outcomes, access to services and medications for behavioral health – including opioid use disorder — and other needs, providers’ financial stability, and employment and the labor market. Research indicates that the expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers.