August 8 Update

In This Week’s Update:

  • National Uninsured Rate Reaches All-time Low
  • Analysis of State Medicaid Enrollment Forms
  • Meeting Social Needs in Tennessee Medicaid
  • Colorado Option Advances Equitable Access to Healthcare
  • Strengthening Communications to Medicaid Enrollees
  • State Updates: AZ, GA, IL, ME, MI, MN, MO, NJ, NY, OR & UT

National Uninsured Rate Reaches All-time Low

Last week, HHS released a report finding the uninsured rate reached an all-time low of 8% earlier this year, with 5.2 million people gaining health insurance coverage since 2020. HHS points to several factors for the coverage gains, including ARPA’s enhanced Marketplace subsidies, Medicaid’s continuous coverage requirement, and recent action by several states to expand their Medicaid programs in accordance with the ACA.

State Health and Value Strategies published State Strategies for Sequencing Enrollee Communications When Medicaid Continuous Coverage Ends, an expert perspective focused on strengthening communications to enrollees once the federal public health emergency is lifted and the continuous enrollment requirement ends. The intention is to help states develop a timeline within their communications plans to coordinate and sequence outreach to consumer groups, to ensure that those who are eligible maintain health coverage, and those who are ineligible are transitioned to a Marketplace plan or other insurance. The expert perspective also outlines outreach strategies and tactics state Medicaid agencies and state-based marketplaces can implement to effectively inform enrollees what is happening and what actions they may need to take to stay insured. 

Colorado Option Advances Equitable Access to Healthcare

Colorado has been gearing up for its official launch of the Colorado Option (HB21-1232), designed to expand affordable, high-quality, dependable, and equitable healthcare access to all Coloradans. The legislation will take effect in January 2023 and specifically aims to make coverage more affordable, with a focus on addressing health disparities and advancing health equity.

Analysis of State Medicaid Enrollment Form Reading Levels

New research from the Institute for Medicaid Innovation (IMI) indicates that some state Medicaid enrollment form readability exceeds recommended levels, potentially creating barriers to care. IMI conducted a review and analysis of state Medicaid enrollment forms from all 50 states and the District of Columbia finding that 39 percent of forms exceed the recommended reading levels. The American Medical Association recommends a maximum 5th grade reading level. The research builds on previously published studies by analyzing more current 2020 state Medicaid enrollment forms to evaluate a) individual form sections, b) compliance with recommended national and state reading levels, and c) differences in readability levels between states that utilized the Centers for Medicare and Medicaid Services (CMS) (“CMS-developed”) form and states that created their own (“state-developed”) forms. The analysis found on average that states who did not utilize the CMS-developed form exceeded the recommended reading levels.

Meeting Social Needs in Tennessee Medicaid

Last year, the TennCare Health Starts Initiative, which aims to address the nonmedical needs of Tennessee Medicaid program members, launched the Health Starts Provider Partnerships. In tandem with its three managed care organizations, the Partnerships selected healthcare provider groups to participate and codesigned workflows within each organization. In a new Milbank Memorial Fund issue brief, Nicolette E. Wise and Karly Campbell of TennCare report on how the practices are integrating support for social risk factors such as conducting screening, implementing consistent referral pathways, and developing processes for member follow-up and data gathering. One lesson gleaned from the first one-year cycle is the importance of adaptability and flexibility, the authors say. Wise and Campbell also share stories of patients who have benefitted from the Partnerships.

  • Arizona – Kristen Challacombe, Deputy Director of Business Operations, appeared on the latest episode of “AHCCCS Explains” (a video series about the state’s Medicaid program) to explain what AHCCCS members can do to prepare for the end of the public health emergency.
  • Georgia – The Georgia Department of Community Health announced that CMS approved the state’s Appendix K emergency preparedness request to implement 2 percent rate increases for certain community waiver services for providers who have struggled during COVID-19. The rate increases apply to two 1915(c) Home and Community-Based Services (HCBS) waivers: Comprehensive Supports Waiver Program and the New Options Waiver.
  • Illinois – Governor Pritzker announced a new expansion of Title X funding through the Illinois Department of Public Health for family planning and reproductive health service providers across the state and an increase in Medicaid reimbursement rates for abortion services. The governor also eliminated a requirement for providers to receive a Medicare denial before requesting Medicaid payment, expanding provider options for patients receiving both Medicare and Medicaid.
  • Maine – Governor Janet Mills announced that her administration has issued $25 million in one-time COVID-19 payments to 211 long-term care organizations to help them recover from the COVID-19 pandemic. Governor Mills proposed the MaineCare (Medicaid) payments in her supplemental budget.
  • Michigan
    • The Michigan Department of Health and Human Services (MDHHS) announced the launch of MIHealthyLife, an initiative to strengthen Medicaid coverage by seeking public input ahead of the next Medicaid health plan procurement. The state is seeking feedback on a variety of priorities, including providing a healthy start for children, reducing racial and ethnic health disparities, and using data to drive outcomes. Survey responses are due on August 26.
    • MDHHS submitted an amendment requesting a one-year extension to implement the §1915(i) state plan amendment for community support services. This request will allow for the state to have additional time to come into compliance with eligibility determination requirements and transition the needs-based eligibility determination from the Pre-Paid Inpatient Health Plans to the state of Michigan. The federal comment period will be open from August 2, 2022 through September 1, 2022.
  • Minnesota – The Minnesota Department of Human Services (DHS) issued an invitation to the LGBTQI+ community to participate in a virtual discussion via Zoom on a set of proposed gender identity data standards for DHS systems. The goal is to better understand the needs of the community and arrive at a set of terms that are comfortable for the majority of individuals, from varied age, ethnic, racial, geographic and experience backgrounds.
  • Missouri – Missouri submitted a section 1115 demonstration application that seeks federal authority to reimburse for medically necessary residential substance use disorder (SUD) services provided in an institution for mental diseases (IMD). The proposed demonstration would authorize reimbursement for SUD IMD services provided in facilities with greater than 16 beds to the demonstration population. Medicaid enrollees ages 12-64 who receive full Medicaid benefits and require a residential level of care for SUD treatment services would be eligible for services under this demonstration. The federal comment period will be open from August 2, 2022 through September 1 , 2022.
  • New Jersey – The Murphy Administration announced that the Department of Human Services has launched a Naloxone Distribution Program in partnership with the Department of Health and the Office of the Attorney General. The program allows eligible agencies the opportunity to request direct shipments of naloxone online anytime they need it.
  • New York – Governor Hochul announced the launch of the Health Care and Mental Hygiene Worker Bonus program. Enacted in the fiscal year 2023 New York state budget, the program includes $1.3 billion allocated for the payment of recruitment and retention bonuses to certain healthcare and mental hygiene workers, a key initiative in the Governor’s aim to increase the state’s healthcare workforce by 20 percent over the next five years.
  • Oregon – The Oregon Health Authority announced it is seeking federal approval to extend Medicaid coverage to individuals up to 200 percent of poverty for 14 months after the end of the PHE, until the state can implement a Basic Health Plan. The request was made to CMS through an amendment to the Oregon Health Plan SUD 1115 waiver. Public comments on the waiver will be accepted through September 7, 2022.
  • Utah – The Utah Department of Health and the Department of Human Services officially merged to create the Utah Department of Health and Human Services. Services have moved to the new department with the exception of Medicaid eligibility, which moves to the Department of Workforce Services to connect families to a single entity for all state economic support services. Some highlights of the organizational changes for the new Department include: joining of behavioral and physical health in the Division of Integrated Healthcare; collocation of Family Health and other community programs with Child & Family Services; and a focus on leveraging data, research, and evaluation across the department to evaluate outcomes for individuals through the new Division of Data, Systems & Evaluation and the Center for Strategic Performance Management.