In This Week’s Update:
- New Medicaid and CHIP Disenrollments
- State Strategies to Improve Healthcare
- 59 Years of Medicaid
- 2024 State Scorecard on Women’s Health and Reproductive Care
- Exploring the Rise in Mental Healthcare Use by Demographics and Insurance Status
- State updates: CA, IL, LA, MI, MT, NC, NJ & WA
59 Years of Medicaid
Last week marked the 59th anniversary of Medicaid being signed into law. Medicaid is the largest provider of healthcare in the U.S., covering over 80 million people. That’s Medicaid, a storytelling project supported by the Robert Wood Johnson Foundation, is recognizing this anniversary by amplifying individuals and families helped by the program, underscoring Medicaid’s value in all 50 states.
2024 State Scorecard on Women’s Health and Reproductive Care
A new Commonwealth Fund scorecard comparing state health system performance on women’s health and reproductive care reveals significant disparities across the U.S. In particular, the researchers find wide gaps between geographic regions and between racial and ethnic groups in deaths among women of reproductive age and in access to essential health services. The report raises concerns over the state of women’s healthcare and the ripple effects of the Supreme Court decision overturning Roe v. Wade. The findings suggest that disparities could widen, with impacts experienced most acutely by women of color and women with low income who live in states that have restricted access to comprehensive reproductive care.
Exploring the Rise in Mental Healthcare Use by Demographics and Insurance Status
KFF published an analysis of recent National Health Interview Survey data, from 2019 to 2022, to understand the latest trends in utilization of mental health services and how it differs by demographics and insured status. The KFF analysis shows that the share of young adults (ages 18 to 26) receiving mental health treatment rose by 45% between 2019 and 2022—a steeper increase than for any other age group. More than one in four young adults (26%) received counseling and/or medication for mental health concerns in 2022, up from 18% three years earlier.
State updates: CA, IL, LA, MI, MT, NC, NJ & WA
- California
- Covered California, the state’s official health insurance Marketplace, announced its health plans and rates for the 2025 coverage year with a preliminary weighted average increase of 7.9%. The preliminary rates have been filed with California’s Department of Managed Healthcare and are subject to final review and public comment.
- The state submitted an addendum to its pending section 1115 demonstration, with the aim of expanding the care continuum for Medi-Cal members with complex behavioral health issues and risk factors. The state proposes to enable county behavioral health plans to opt into one or both of two new opportunities: (1) community transition in-reach services; and (2) room and board in enriched residential settings.
- Illinois
- Governor JB Pritzker announced that CMS approved the state’s request to amend and extend its Healthcare Transformation 1115 demonstration waiver. Under the extension the state received authority to provide: (1) services to address health-related social needs, with a focus on housing support, medical respite, and food and nutrition; (2) coverage for pre-release services for individuals leaving carceral settings; (3) services to address community firearm violence; (4) expanded home and community-based services, including non-medical transportation; and (5) substance-use disorder (SUD) assistance as well as coverage of Violence Prevention and Intervention services for enrollees impacted by violence.
- Governor Pritzker signed the Birth Equity Initiative into law. The bill ensures competitive Medicaid reimbursement rates for doulas, lactation consultants, home visitors, and other community-based care providers who help birthing individuals before, after, and during birth. For more information on how states can leverage payment to improve maternal health outcomes, see the SHVS issue brief Maternal Health Providers: Enhancing Health Equity Through Payment Parity.
- Louisiana – The Louisiana Department of Health released for public comment a draft application to CMS for an 1115 demonstration waiver to improve care transitions for Medicaid-eligible individuals who are incarcerated and to provide certain covered services during the 90-day pre-release period. Individuals participating in the demonstration will have access to services including case management, medication-assisted treatment and counseling for SUDs, and a 30-day supply of all prescription medications. Eligible carceral settings will include all state prison facilities and up to 13 parish jails. For more information on the opportunity for states to provide certain pre-release healthcare services to justice-involved populations, see the SHVS webinar, Section 1115 Demonstration Opportunity to Support Reentry for Justice-Involved Populations: CMS Guidance.
- Michigan – The Michigan Department of Health and Human Services (MDHHS) is providing grants to improve partnerships between hospitals, community-based organizations and hospice, and to fund activities to address the critical need for support following the death of a mother or infant. Leveraging a $490,000 grant to the Division of Maternal and Infant Health from the Michigan Health Endowment fund, MDHHS, in partnership with Michigan 211, has launched a new website dedicated to increasing access to grief and bereavement support services and resources.
- Montana – Governor Greg Gianforte announced funding of up to $1 million to conduct a statewide study of how to subsidize housing costs for low-income Montanans served in the state’s behavioral health (BH) system. Individuals served by the state’s BH and Developmental Disabilities systems are increasingly unable to access affordable housing. Through the study, information will be gathered on current rental rates throughout the state to help determine the funding necessary to supplement federal rental assistance.
- New Jersey
- Governor Phil Murphy signed A2027/S2330 to establish a menstrual hygiene benefit program and a diaper benefit program through Work First New Jersey (WFNJ), the state’s cash assistance program. The programs will allow certain eligible adults ages 18 through 50 to purchase menstrual hygiene products using a $14 monthly state benefit, and individuals with a dependent under 36 months of age who participate in WFNJ will receive a $30 monthly state benefit for diapers.
- Commissioner Sarah Adelman and State Chief Innovation Officer Dave Cole launched a Disability Information Hub website. The Hub will serve as a one-stop shop to connect New Jerseyans with disabilities, their families, caregivers, and advocates with state services and resources in an accessible format.
- North Carolina
- CMS approved the state’s plan to use Medicaid reimbursement to incentivize hospitals to relieve existing medical debt for eligible North Carolinians and prevent accumulation of future debt. The North Carolina Department of Health and Human Services will work with hospitals to implement the program, which has the potential to relieve up to $4 billion in existing debt. SHVS updated its expert perspective tracking state efforts against medical debt.
- Governor Roy Cooper announced that beginning August 1, the oral contraceptive Opill will be available through local and retail pharmacies without a prescription, at no cost for North Carolina Medicaid enrollees.
- Washington – The Office of the Insurance Commissioner issued a report studying five potential policy options that could make healthcare more affordable in Washington. The report, delivered to the Legislature, uses pricing data to provide an economic and actuarial analysis of each policy option that estimates savings for consumers, organizations and the state’s economy. A fact sheet on the final report is also available here.