In This Week’s Update:

• Updated Toolkit: Unwinding Federal Medicaid Flexibilities
• State Budgets and Health Programs in Response to COVID-19
• COVID-19 State Updates: AZ, CA, MA, MD, ME & NJ
• Other State Updates: CO, HI, MN, NJ, NV, OR, PA & VA
• Ensuring Safe Access to Necessary Care
• Changes in Coverage Due to COVID-19

 

Updated Toolkit: Unwinding Federal Medicaid Flexibilities

In light of the announcement last week of the renewal of the Public Health Emergency (PHE) Declaration by Secretary Azar, State Health and Value Strategies (SHVS) published an updated version of Coronavirus (COVID-19) Unwinding Federal Medicaid Flexibilities: Issues and Considerations for States, a tool for states as they strategize and plan for the next phase of the COVID-19 pandemic. The PHE is now set to expire on Thursday, October 22 absent another renewal. States can use the template to determine which flexibilities to unwind or maintain and plan for operational and implementation implications.

    State Budgets and Health Programs in Response to COVID-19

SHVS updated its expert perspective State Budget Actions in Response to COVID-19 and the Impact on State Health Programs to capture how states are navigating the fiscal challenges caused by the COVID-19 pandemic. As states face looming double-digit deficits for fiscal year 2021, SHVS will continue to track the steps they take to balance their budgets and the implications for health care.

 

COVID-19 State Updates: AZ, CA, MA, MD, ME & NJ

• Arizona – Governor Doug Ducey announced the establishment of a Task Force On Long-Term Care. The task force will focus on developing recommendations and metrics on how and when visitation within long-term care facilities can be safely resumed and what steps facilities can take before then to help residents and their loved ones maintain contact.
• California – Due to the recent surge in COVID-19 cases throughout the state, Covered California announced that it would give consumers additional time to sign up for health care coverage during the pandemic by extending the current special enrollment deadline to the end of August. The most recent data shows that 231,040 people have signed up through Covered California for health care coverage between March 20 and July 25.
• Maine – Governor Janet Mills announced that MaineHousing will double its rental assistance from $500 to $1,000 through the COVID-19 Rental Relief Program beginning August 3. The governor is dedicating an initial $5 million in Coronavirus Relief Funds to support the expansion. The governor also signed an Executive Order continuing expanded time frame protections for renters in the evictions process.
• Maryland – The Maryland Health Benefit Exchange announced that nearly 58,000 Marylanders enrolled in health coverage during Maryland Health Connection’s two special enrollment periods that began in February and March and ended Wednesday, July 15.
• Massachusetts – The Baker-Polito Administration announced nearly $3 million in grants to address urgent food insecurity for Massachusetts residents as a result of the COVID-19 pandemic. This funding is being awarded as part of the first round of the new $36 million Food Security Infrastructure Grant Program, created following recommendations from the administration’s COVID-19 Command Center’s Food Security Task Force.
• New Jersey – Governor Phil Murphy signed an Executive Order to establish the Governor’s Disaster Recovery Office to lead the state’s COVID-19 recovery efforts. The office is charged with providing greater oversight and accountability for federal COVID-19 resources.

 

Other State Updates: CO, HI, MN, NJ, NV, OR, PA & VA

• Colorado – The Colorado Division of Insurance released the preliminary premium information for individual and small group health plans for 2021 for public comment. The agency calculated that for 2021, the state’s reinsurance program will save Coloradans an average of 17.4 percent over what premiums would have been without reinsurance.
• Hawaii – The Department of Human Services Med-QUEST Division issued a Request for Information to seek information and comments to prepare a request for proposal for the QUEST Integration re-procurement of QI health plans.
• Minnesota – The state launched its Medicaid housing support services program, Housing Stabilization Services. The new state Medicaid benefit is designed to help people with disabilities and seniors find and keep housing. Minnesota is the first state to have received federal approval for such a program.
• Nevada – The Silver State Health Insurance Exchange, Nevada’s state-based marketplace, announced an extension of its open enrollment period (OEP) for plan year 2021 through January 15, 2021.
• New Jersey – The state legislature passed legislation to implement a state-level health insurance assessment (HIA), which the governor is expected to sign. The 2.5 percent HIA will be used to support state programs aimed at improving affordability of health care, including the state’s reinsurance program as well as a state-based subsidy. In addition, Governor Phil Murphy, alongside Department of Banking and Insurance Commissioner Marlene Caride, health care advocates, and legislators, hosted a virtual roundtable to discuss the importance of supporting residents and small businesses with the cost of purchasing health care coverage through the development of a state-level HIA.
• Oregon – The Oregon Health Insurance Marketplace awarded grants totaling $786,500 to nonprofit community groups and insurance agents. Awardees use these grants to spread awareness of the upcoming marketplace health insurance OEP and to help Oregonians enroll in coverage through HealthCare.gov and the Compact of Free Association Premium Assistance Program.
• Pennsylvania
  • Governor Tom Wolf announced the federal government approved Pennsylvania’s Section 1332 waiver application for a reinsurance program, beginning 2021 through 2025. The SHVS map has been updated to reflect this latest development.
  • The Office of Advocacy and Reform released the “Trauma-Informed PA” plan to guide the Commonwealth and service providers statewide on what it means to be trauma-informed and healing-centered in the state.
• Virginia
  • The Virginia Department of Medical Assistance Services (DMAS) released a report demonstrating that the state has an adequate network of primary care providers to ensure access to care in the Commonwealth, with a significant majority of providers currently treating Medicaid members and accepting new patients with Medicaid coverage.
  • DMAS received federal approval to offer housing and employment support services for Medicaid members who have significant behavioral and physical health needs. The new benefit will become available in July 2022 for Virginia Medicaid members ages 18 and older, contingent on approval and funding by Governor Ralph Northam and the General Assembly.

 

Ensuring Medicaid MCO Enrollees Receive Necessary Care During COVID-19

SHVS published an expert perspective authored by Michael Bailit and Jennifer Sayles from Bailit Health that outlines steps states can take to ensure Medicaid beneficiaries are receiving necessary care during the COVID-19 pandemic. States are grappling with how to ensure Medicaid beneficiaries can safely access medically needed services. The expert perspective outlines actions states can take to ensure their Medicaid managed care plans are delivering needed services during the course of the pandemic. Recommendations include measuring the effect of COVID-19 on Medicaid managed care organization (MCO) enrollees and assessing what steps MCOs have taken to address member needs, including those of subpopulations, during the pandemic.

 

Changes in Health Insurance Coverage Due to the COVID-19 Recession

The Urban Institute published an issue brief summarizing preliminary estimates using microsimulation of changes in health insurance coverage as a result of the COVID-19 recession.  Through support from the Robert Wood Johnson Foundation, the Urban Institute developed the Health Insurance Policy Simulation Model, which incorporates data on employment losses by industry, state, and demographic characteristics, allowing researchers to simulate employment losses matching actual employment losses reported by the government. The microsimulation estimates that 48 million people will live in families with a worker who experiences a COVID-19-related job loss in the last three quarters of 2020. Of them, 10.1 million will lose employer coverage tied to that job and of them, it is estimated that 3.5 million people will become uninsured.