August 9 Update

In This Week’s Update:

  • New SHVS Resource: Equitable Vaccine Distribution
  • Event: Strategies for States to Drive Equitable Vaccine Distribution and Administration                             
  • State Updates: AL, CT, IL, MT, NC, ND, NH, NM, NY, PA, RI, VA & WI  
  • Health Insurance Among Workers with Disabilities  
  • State Health Policy Resources from Altarum
  • Impact of COVID-19 and Federal Policies on Small Business Insurance

 

Vaccinating Under-Resourced Communities

As the country continues to grapple with the COVID-19 pandemic and new variants of the virus that are more transmissible and potentially more likely to result in severe illness or death, widespread vaccination against COVID-19 remains the strongest tool to fight the virus. But while the United States has administered more than 330 million COVID-19 vaccine doses, efforts to date have not produced equitable outcomes. State Health and Value Strategies (SHVS) published an expert perspective, which shares highlights from a new issue brief, Strategies for States to Drive Equitable Vaccine Distribution and Administration. The issue brief outlines the key barriers states face in their efforts to increase vaccination rates among Black, Indigenous and people of color (BIPOC) and highlights strategies states are pursuing in partnership with community-based organizations (CBOs) to address these challenges. The brief also considers future phases of the COVID-19 vaccine rollout and planning, including near-term efforts to vaccinate children and adolescents, as well as longer-term opportunities to build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems.

 State Updates

  • Alabama – Governor Kay Ivey announced sensory-inclusive training for state law enforcement officers. Through a partnership between the Alabama Law Enforcement Agency and KultureCity, the program will provide training to improve interactions between law enforcement and individuals with sensory needs.
  • Connecticut – Access Health CT, the state-based marketplace, is extending the special enrollment period for Connecticut residents to shop, compare and enroll in health insurance plans. The new deadline to enroll in a 2021 health insurance plan through Access Health CT is October 31. Customers can enroll online, by phone or in-person.
  • Illinois
    • The Illinois Department of Public Health and Illinois Department of Healthcare and Family Services announced the Diabetes Prevention Program and the Diabetes Self-Management Education and Support Program will be newly eligible for Medicaid coverage in Illinois, upon final federal approval. The Diabetes Prevention Program (DPP) involves a yearlong, evidence-based lifestyle change aimed at reducing the risk of adults with prediabetes progression to Type 2 diabetes; a CDC-conducted evaluation of the DPP has found a 58 percent reduction in the risk of developing Type 2 diabetes. CDC-recognized DPP organizations can enroll as Illinois Medicaid providers to deliver the program to eligible participants by administering services during regular sessions over the course of the year, including dietary and nutritional counseling, fitness assessments and educational sessions on how to prevent Type 2 diabetes.
    • Governor JB Pritzker signed three pieces of legislation making feminine hygiene products more accessible for women and girls in Illinois. The three pieces of legislation, House Bill 641, House Bill 155, and House Bill 310, all remove financial barriers that have previously prevented individuals from purchasing hygiene products. The legislation builds on steps already taken by the administration to expand reproductive equity and protect women’s access to health care.
  • Montana – Governor Greg Gianforte announced that the state will invest federal funds from the American Rescue Plan Act (ARPA) to prevent child abuse, expand the Supplemental Nutrition Assistance Program (SNAP), the Employment and Training program, and provide early intervention services and supports for families with infants and toddlers with significant developmental delays or disabilities. The governor also announced the allocation of more than $32 million in federal funds to support COVID-19 screening and testing in schools.
  • New Hampshire – The state’s Department of Health and Human Services announced its intent to request from CMS an amendment to the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver. The proposed amendment will expand the scope of the waiver to include coverage for short-term inpatient and residential treatment services for beneficiaries with Serious Mental Illness (SMI), and would allow Medicaid to pay for short-term stays in Institutions for Mental Disease for beneficiaries ages 21-64 with SMI who are approved for full Medicaid benefits under the State Plan.
  • New Mexico – To combat blood shortages as a result of COVID-19, the New Mexico Department of Homeland Security and Emergency Management (DHSEM) and the Department of Health (DOH) have partnered with Vitalant to raise awareness of the critical need for blood donors, highlight donation events across the state, and recruit ambassadors among the state’s health and emergency management professionals to amplify this message in their communities. 
  • New York – The state announced Excelsior Pass Plus, a secure, digital copy of a resident’s COVID-19 vaccination record. The Pass Plus provides safe access to vaccination information, and includes vaccine type, site, and date of the vaccination, just like a resident’s CDC Vaccination Card. The inclusion of this health information enables residents to have a verifiable record of your COVID-19 vaccination history at their fingertips, for record-keeping and/or usage outside of New York State. A Pass Plus can be accessed through the NYS Excelsior Pass Wallet app, or through the Excelsior Pass Web Portal and printed. The Pass Plus is currently available in English. Additional languages will be rolled out in the near future.
  • North Carolina – The North Carolina Department of Health and Human Services is expanding the COVID-19 Community Health Worker program, bringing it statewide. El Centro Latino and UNETE join six other vendors that were previously selected for this work to aid in North Carolina’s efforts to connect those affected by COVID-19 with needed support, including assistance with COVID-19 vaccinations.
  • North Dakota –  Officials announced the launch of the North Dakota Department of Human Services’ Early Childhood Division. The Early Childhood Division was created in July 2021 to align and focus programs and resources on early childhood experiences. A key purpose of the division is building greater access to quality early childhood experiences to help children reach their potential. Speakers also announced several new developments supporting quality early childhood experiences for children ages zero to five.
  • Pennsylvania – The Wolf Administration announced Pennsylvania’s intent to extend the postpartum coverage period for mothers eligible for Medicaid because of their pregnancy. As a reminder, under the American Rescue Plan Act, states are able to implement a new state plan option beginning April 1, 2022, to expand the Medicaid postpartum coverage period for mothers to one year following the birth of a baby. The state will submit a formal declaration of intent to expand the postpartum coverage period to the federal government once guidance is issued to states from CMS.
  • Rhode Island – Governor Dan McKee signed multiple pieces of legislation that will support women’s health and equity in Rhode Island, including legislation that ensures pay equity for all employees, regardless of gender or ethnicity, bans health insurers from using gender rating, and requires all public schools to provide feminine hygiene products at no cost.
  • Virginia – The Virginia Department of Medical Assistance Services released a new report highlighting a significant increase in access to addiction and recovery treatment services as a result of Medicaid expansion. More than 46,500 Medicaid members received care through the Addiction and Recovery Treatment Services (ARTS) benefit in 2019, the first year eligibility for health coverage expanded to more low-income adults, including childless adults who had been excluded under previous policies. Participation in ARTS increased 79 percent between 2018 and 2019.
  • Wisconsin
    • The Wisconsin Department of Health Services (DHS) announced that Wisconsin will receive nearly $50 million in additional funding from the federal government to address mental health and substance use needs. The funding—part of the ARPA —will add $24.6 million to mental health services and $22 million to substance use services over the next four years through supplements to Wisconsin’s existing share of the Community Mental Health Services Block Grant and the Substance Abuse Prevention and Treatment Block Grant. DHS has submitted plans for this funding to the federal Substance Abuse and Mental Health Services Administration.
    • Governor Tony Evers introduced the “Less for Rx” prescription drug plan. This legislative package is comprised of bold initiatives proposed by Governor Evers as part of his 2021-2023 biennial budget earlier this year and builds on the work of the Governor’s Task Force on Reducing Prescription Drug Prices with more than a dozen innovative and effective policy solutions to reduce the price of prescription drugs and ensure Wisconsinites can access and afford the medications they need.

 

Strategies for States to Drive Equitable Vaccine Distribution and Administration                             

Thursday, August 12 from 3:00 to 4:00 p.m. ET

State Health and Value Strategies is hosting a webinar during which experts from Manatt Health and Health Equity Solutions will provide an overview of the strategies states can pursue in partnership with community-based organizations to reduce disparities in COVID-19 vaccine uptake, and in the longer term, to build a more equitable and sustainable public health system. While more than 20 states and the District of Columbia reached the Biden administration’s goal of administering one or more COVID-19 vaccine doses to at least 70 percent of adults by early July, wide variation in vaccination rates persists across communities within these states and among the 30 states still working to reach this goal. This variation in vaccination rates at the community level translates to disparities across racial and ethnic groups, as most states continue to have disparities in vaccination rates between Black, Indigenous and people of color (BIPOC) and white populations. States and their community partners are implementing a broad range of distribution and outreach strategies to improve vaccine equity, including by increasing access points, improving vaccine confidence, combating misinformation, and addressing structural barriers to vaccination for BIPOC. In addition, states are beginning to look ahead to establish strategies to vaccinate children and adolescents and build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e6a3993a5dde2ff83a0acddf35aec2d85

 

Health Insurance Coverage Among Working-Age Adults with Disabilities: 2010-2018

For working-age adults with disabilities, consistent access to health insurance may be critical to continuity of care and good health outcomes. An issue brief by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy tracks changes in health insurance coverage for this population from 2010-2018. From 2010-11 to 2017-18, the proportion of U.S. adults with disabilities who lacked health insurance coverage for a full year was nearly halved, falling by about 46 percent from 17 percent to 9 percent. There was also an increase of about 14 percent in the proportion of adults with disabilities who had continuous coverage, from about 71 percent to 81 percent. These improvements were concentrated immediately after 2014, when the largest Affordable Care Act-driven insurance expansions first took effect. Coverage gains were particularly large for Medicaid, coinciding with the Affordable Care Act’s (ACA) Medicaid expansion program that took effect in most states starting in 2014. Having coverage for only part of the year, however, remained more than 50 percent more common for adults with disabilities (10 percent in 2017-18) than those without disabilities (6 percent in 2017-18) throughout the study period. The American Rescue Plan of 2021 (ARP) expanded subsidies for Marketplace plans, which has the potential to increase coverage further for adults with disabilities. An estimated 532,000 uninsured adults with disabilities (about 67 percent) now have access to a zero-premium plan after premium tax credits on Healthcare.gov, an increase of 16.8 percentage points from pre-ARP estimates.

 

State Health Policy Resources

With support from the Robert Wood Johnson Foundation, Altarum’s Healthcare Value Hub recently published a series of resources for states and other stakeholders on health equity efforts in states, affordability efforts in states, and consumers’ view on the health care system more generally. The Health Equity Policy Checklists allow consumer advocates, state policymakers and others to assess how well their state’s policy environment supports health equity and identify areas for improvement by evaluating states’ performance on 39 health equity-related policies across six domains. The Healthcare Affordability Policy Checklists allow consumer advocates, state policymakers and others to (1) assess how well their state’s policy environment supports health care affordability and (2) identify areas for improvement by evaluating states’ performance on 15 health care affordability-related policies across four domains. Finally, Altarum’s Consumer Healthcare Experience State Survey (CHESS) is designed to elicit respondents’ unbiased views on a wide range of health system issues, including confidence using the health system, financial burden and views on fixes that might be needed. Survey results are published in the form of Data Briefs on a select number of states.

 

The Impact of the COVID-19 Pandemic and Recent Federal Policies on Small Business Health Insurance

A new issue brief published by the Urban Institute with support from the Robert Wood Johnson Foundation examines the effect the COVID-19 pandemic has had on the small group insurance market. Researchers conducted structured discussions with insurers, small businesses, and brokers in six states to assess the impact the pandemic has had on the small group market and any changes to coverage during the pandemic. Despite being some of the hardest hit employers, small employers did all they could to maintain their health plans. Small employers we spoke with view health coverage as a necessary recruitment and staff retention tool and so were hesitant to cut benefits. However, the small group market as a whole rests on a shaky foundation as employers look to cut costs and pursue non-ACA compliant coverage options.