August 30 Update

In This Week’s Update:

  • Expanding the Public Insurance Navigator Workforce
  • Medicaid Managed Care and Health Equity Resource
  • State Updates: CA, CO, IL, KS, MD, MN, NJ, NV, NY, PA & OR
  • Changes in Federal Data Due to COVID-19
  • Provider Attitudes Towards SDOH Screening
  • Opportunities for Improving Pediatric Care

 

HHS Expanding Public Insurance Navigator Workforce 

The U.S. Department of Health and Human Services announced that it is expanding the number of Navigator organizations to help people enroll in coverage through the Marketplace, Medicaid, or the Children’s Health Insurance Program in 30 states with a Federally-Facilitated Marketplace. HHS is awarding $80 million in grants for the 2022 plan year to 60 Navigator organizations to train and certify more than 1,500 Navigators to support uninsured consumers. 

 

Health Equity Resource for Managed Care

State Health and Value Strategies published a revised version of Medicaid Managed Care Contract Language: Health Disparities and Health Equity. This resource compiles excerpts of health disparities and health equity language from Medicaid managed care contracts and requests for proposals from 15 states and the District of Columbia as well as the contract for California’s state-based marketplace, Covered California. This is the fourth revision of this compendium since its original release in June 2020 and the latest iteration includes new language from Medicaid programs in California, Indiana, Louisiana, and Nevada. Also, a new expert perspective, States Are Leveraging Medicaid Managed Care to Further Health Equity, that highlights the new additions to the compendium. 

 State Updates

  • California – Covered California announced that the statewide weighted average rate change for dental coverage in 2022 will be a decrease of 1.0 percent. The latest data shows that more than 230,000 people are enrolled in Covered California’s dental plans, which represents a 15 percent increase over last year.
  • Colorado
    • The Colorado Division of Insurance is hosting a series of virtual stakeholder meetings designed to address specific stakeholder groups and the concerns of those groups regarding the Colorado Option and the standardized benefit plan being developed. Starting in 2023, the Colorado Option will be available to all Coloradans who buy their health insurance on the individual market and small employers with less than 100 employees. As part of the Colorado Option, the Division of Insurance will create a standardized plan which will allow consumers and businesses to easily compare plans and choose the plan that is right for them.
    • Connect for Health Colorado, the state-based marketplace, announced that as of August 15, the last day of the enrollment period, more than 200,000 Coloradans have signed up for a plan that provides coverage this year. That total is 21,000 more health insurance plan sign ups than the same day last year—a nearly 11 percent increase.
  • Illinois – Governor JB Pritzker signed two pieces of legislation into law to expand the mental health care infrastructure in Illinois. House Bill 2595 requires medically necessary mental health care, including coverage for mental, emotional, nervous or substance use disorders, to be covered by insurance beginning January 1, 2023. Additionally, House Bill 2784 creates a first responder system that will coordinate 911 and 988 emergency responses when the national 988 mental health crisis line is established in the summer of 2022. This initiative aims to reduce arrests for those with mental illnesses. 
  • Kansas
    • The Kansas Department of Health and Environment announced the release of the Kansas COVID County Ranking report. This report is designed to help county commissioners and local leaders stop the spread of COVID-19 in their communities by tracking critical COVID-19 metrics including testing, case and vaccination rates.
    • As the Delta variant continues to rapidly spread and recent federal data shows a record-high number of children are hospitalized because of COVID-19, Governor Laura Kelly released two new ads encouraging students and their families to use public health practices as they head back to school this fall. The first ad, “Kids Spread Germs,” talks about just how contagious and serious the Delta variant is and urges parents to follow three core steps to keep kids safe. The second ad, “Your Decision,” urges college students who are over the age of 18 to get the information they need and make the decision to get a free and safe vaccine.
  • Maryland – The Maryland Health Benefit Exchange, the state-based marketplace, announced that more than 200,000 Marylanders enrolled through the Coronavirus Emergency Special Enrollment on Maryland Health Connection from March 16, 2020 to its conclusion on August 15, 2021.
  • Minnesota – Governor Walz announced the conclusion of Minnesota’s $100 COVID-19 vaccine incentive program, with nearly 80,000 Minnesotans who received their first dose of vaccine since July 30 signing up for the reward. The program has helped drive up Minnesota’s vaccination rate over the past month and was particularly popular among Minnesotans whose vaccination rates are lower than the statewide average. Governor Walz initially authorized $2.5 million in American Rescue Plan funding to start the rewards program and the legislative COVID-19 Response Commission approved an additional $13.8 million to ensure the program’s funding would meet demand.
  • Nevada – Nevada Health Link, the state-based marketplace, announced that more than 17,000 Nevadans took advantage of premium savings during an open enrollment period created by the American Rescue Plan. The online insurance marketplace increased total enrollments by 7.6 percent during the American Rescue Plan enrollment period.
  • New Jersey – The New Jersey Department of Health awarded a $450,000 grant to HealthConnect One to develop a diverse community doula workforce to support women during pregnancy, birth, breastfeeding and early parenting. HealthConnect One will establish a Doula Learning Collaborative to increase the number of trained community doulas. The Doula Learning Collaborative will also support doulas in engaging with multiple health systems and process Medicaid reimbursement claims for their services.
  • New York – The New York State Department of Health Office of Health Insurance Programs published a Section 1115 Waiver Demonstration: Conceptual Framework focused on building a federal-state partnership to address health disparities exacerbated by the COVID-19 pandemic. The state is requesting $17 billion over five years to support an array of multi-faceted and linked initiatives in order to change the way the Medicaid program integrates and pays for social care and health care in the state.
  • Pennsylvania – The Pennsylvania Departments of Education, Health, Human Services and Insurance are reminding families to ensure their children’s immunizations are up to date as part of back-to-school preparations. Immunization requirements also extend to students of cyber and charter schools. The departments are reminding residents that under the ACA, most insurance plans, including those bought through the federal Marketplace, as well as the Children’s Health Insurance Program (CHIP) and Medicaid, are required to cover school vaccinations as a free preventive service without charging a copayment or coinsurance.
  • Oregon – The Division of Financial Regulation released its final rate decisions for 2022 health insurance plans. The division announced a weighted average increase of 1.5 percent in both the individual market as well as the small group market. Additionally, the Oregon reinsurance program continues to help stabilize the market—lowering rates by 6 percent for the fourth straight year.

 

Changes in Federal Surveys Due to and During COVID-19

The U.S. Census Bureau recently announced that they will not be releasing 2020 data from the American Community Survey (ACS) as usual in September. Instead, due to the impact of the coronavirus pandemic, “experimental” estimates will be available in November. This substantial change to the data release of a major federal survey highlights one (among many) of the disruptive effects of the coronavirus—the interruption of data collection processes and falling response rates for yearly federal surveys. A new issue brief from our colleagues at SHADAC summarizes COVID-era changes and challenges for four major federal surveys—American Community Survey (ACS), Current Population Survey (CPS), Medical Expenditure Panel Survey (MEPS), and National Health Interview Survey (NHIS)—and explains what effects these adaptations may have for understanding 2020 data as it becomes available.

 

Health Care Providers’ Attitudes and Behaviors Around SDOH Screening and Referral Programs

A new issue brief published by the Social Intervention Research & Evaluation Network (SIREN) at the University of San Francisco California examines the research on health care providers’ knowledge, attitudes and beliefs, and behaviors (KABB) about socioeconomic risk screening and referral programs. Despite growing investment from the health care sector in social care initiatives, little information has been compiled about health care providers’ perceptions of both the need for and capacity to implement screening and referral programs. In an era of increasing documentation demands, time pressures, and provider burnout, understanding the provider impacts of these activities is foundational to program implementation and sustainability.

 

Accelerating Child Health Care Transformation: Key Opportunities for Improving Pediatric Care

Pediatric health care providers and their multidisciplinary care teams are uniquely poised to affect life-long health and well-being by supporting opportunities to prevent development delays, address health-related social needs, and reduce the risk of chronic disease, trauma, and mental health difficulties. Drawing from conversations with child health care leaders nationally and a literature review, the Center for Health Care Strategies, with support from the Robert Wood Johnson Foundation, identified three key strategies, profiled in a new report, that are integral to support a more upstream, preventive, holistic pediatric delivery system model that treats all patients with dignity and respect. These strategies create the underpinnings for improving children’s health care beyond medical care, centering child and family well-being, and incorporating an upstream approach to prevention.