August 21 Update

In This Week’s Update:

  • Medicaid’s Role in Small Towns and Rural Areas
  • State Agency Partners Navigating the Unwinding
  • Eligibility and Enrollment Performance Indicator Unwinding Data
  • State updates: AZ, CT, DE, MA, MD, MI, MN, NY, OR, RI & WY


Medicaid’s Role in Small Towns and Rural Areas

As described in a report from the Georgetown University Center for Children and Families, Medicaid and CHIP are more important than ever for the children and families living in small towns and rural areas. Medicaid enrollment has grown in recent years during the continuous coverage protection, but these coverage gains are at dire risk during the unwinding. Working together with stakeholders in rural areas; monitoring data on enrollment and renewals; successfully implementing 12-months continuous eligibility for children in those states that have not adopted it; and adopting policies like Medicaid expansion and multi-year continuous eligibility can help ensure that eligible families remain covered.


State Agency Partners Navigating the Unwinding

Over the past few months, members of Benefits Data Trust’s (BDT) Policy and Research teams have crossed the country to meet with state Medicaid agencies to help eligible families stay covered by Medicaid. In a blog post, BDT reports three findings from conversations with states: dedicated work time on a larger churn strategy can pay dividends; states want to learn from one another; and states are looking to carry new innovations beyond the Medicaid unwinding. On Thursday, August 24, BDT will host a webinar discussion with Rhode Island on the unwinding, lessons learned, and strategies the state is using to help eligible residents stay covered. Registration for the webinar, made possible with support from the Robert Wood Johnson Foundation, is available here.


Eligibility and Enrollment Performance Indicator Unwinding Data

CMS sent letters to all states reviewing their respective unwinding data on three sets of metrics for Medicaid and CHIP. For some states CMS highlighted concerns, including long call center wait times, a high share of procedural disenrollments and long application processing times. The Center on Budget and Policy Priorities created a chart summarizing these metrics. The letters, and the data they include, vary greatly across states, some of which can be explained by states being at different stages of the unwinding process. These letters are an important step to document areas of concern so that states can address them.


State updates: AZ, CT, DE, MA, MD, MI, MN, NY, OR, RI & WY

  • Arizona – The Arizona Health Care Cost Containment System and the Arizona Department of Economic Security have upgraded search features on Health-e-Arizona Plus, the enrollment and eligibility website for Medicaid, SNAP, and cash assistance applicants and enrollees. Now users can search for community assistors, organizations and individuals who help Arizonans enroll in benefit programs, by zip code or full or partial address. The new “Locate Me” feature returns geolocated results without the user having to input anything. The upgrade also allows users to search by radius and proximity to find assistors up to 50 miles away.
  • Connecticut – Governor Ned Lamont and Education Commissioner Charlene Russell-Tucker announced the release of more than $4.5 million in funding for 48 school districts and summer camp programs across Connecticut that will be used to support the delivery of mental health services for students during the summer months over a three-year period. The state is utilizing funding received from the federal American Rescue Plan Act.
  • Delaware – Governor John Carney signed House Bill 80, which requires that doula services be covered by Medicaid in Delaware by January 1, 2024.
  • Maryland
    • The Maryland Department of Health has launched a new website which lists vaccination clinics offered by local health departments statewide, including children’s back-to-school and COVID-19 clinics. The new site will also list flu vaccination clinics when available.
    • The Maryland Department of Health announced Strengthening Families in Recovery, a pilot program to support pregnant and parenting women recovering from substance and opioid-use disorders. This pilot program, which is slated to enroll 750 women, is funded by a three-year, $900,000 per year grant from the Substance Abuse and Mental Health Services Administration. This money will fund additional recovery support coordinators, pregnant parenting women navigators, and family support coaches to help enrolled women navigate administrative barriers.
  • Massachusetts – The Massachusetts Health Connector, the state’s official health insurance Marketplace, board of directors approved regulatory changes that will expand access to the Marketplace’s ConnectorCare subsidy program through a two-year pilot program. The regulatory changes include expanding the income limits from 300% to 500% of the federal poverty level and all Marketplace carriers to participate in the program for the first time. The changes will provide cost savings to more than 50,000 people and will go into effect for 2024 plans.
  • Michigan – The Michigan Department of Health and Human Services (MDHHS) announced it has renewed Medicaid enrollment for more than 121,000 people whose eligibility was up for redetermination in July. There were 9,121 people who were disenrolled in July because they were no longer eligible and 1,779 whose eligibility was not renewed for procedural reasons. MDHHS also announced it has gained approval of eight federal waivers to implement additional strategies for renewing coverage and has submitted two other requests that are being considered.
  • Minnesota – Governor Tim Walz appointed former Minnesota Department of Health Commissioner Jan Malcom to lead a new task force that will develop recommendations to support the University of Minnesota’s Health Sciences Programs. The recommendations will support academic health professions education, research and care delivery by the Health Sciences Programs that advance equity and center primary care.
  • New York – Superintendent of Financial Services Adrienne A. Harris announced proposed regulations to govern the conduct of pharmacy benefit managers operating in New York. These regulations establish strong protections for consumers and small businesses including prohibiting abusive contract terms that raise drug costs for consumers and strain small pharmacies, as well as establish network adequacy standards to ensure consumers have access to affordable prescriptions. The proposed regulations are subject to a 60-day public comment period.
  • Oregon
    • The Oregon Health Authority released its 2022 report on coordinated care organization (CCO) metrics, which tracks the quality of healthcare delivered to Medicaid members. A metrics dashboard is also available to review CCO performance over time and view data breakouts for various race, ethnicity, language and disability categories. The 2022 report shows that CCOs improved year over year in the following areas: diabetes care, substance-use disorder treatment, preventative dental treatment for kids, assessments for children in foster care, prenatal and postpartum care; and depression screenings and follow-up. Improvements are needed in childhood well-care visits and child immunization rates.
    • Governor Tina Kotek hosted a signing ceremony for two bills that support patients and healthcare providers. House Bill 2002 creates protections for patients seeking reproductive and gender affirming care and for providers administering that care and closes insurance coverage gaps for gender affirming care. House Bill 2697 creates a minimum nurse-to-patient staffing ratio and establishes committees for hospital care providers to improve staffing.
  • Rhode Island – The Executive Office of Health and Human Services (EOHHS) opened the application for a second round of mini-grants totaling $100,000 for community-based organizations to support Medicaid renewals. Community organizations can apply for up to $4,950. Awarded funds can be used to cover costs associated with enhancing the organization’s technology, training, outreach, and language and cultural competency. In a previous round of mini-grant distribution, EOHHS awarded nearly $100,000 to 20 community organizations. Since those grants were awarded in May, organizations have reported assisting hundreds of Medicaid members with their renewal and distributing educational materials at dozens of events.
  • Wyoming– The Wyoming Department of Health released a new smartphone application to help families check whether their children have all the vaccinations they need. The app can be used to view and share vaccination records and to find out what vaccinations are due. The records that can be viewed come from the Wyoming Immunization Registry.