February 10 Update

In This Week’s Update:

  • Widening Gap in Maternal Mortality Rates
  • Preserving No-Cost Preventive Services
  • ACA Premiums Set to Rise if Enhanced Subsidies Expire
  • Underinvestment in Primary Care is Impacting Patients
  • The National Academy for State Policy (NASHP) Hospital Cost Tool 4.0 Launch
  • State updates: AR, CA, CT, FL, GA, IL, MD, MN, NC, NJ, NY, RI & WI

 

Widening Gap in Maternal Mortality Rates
Last week, the U.S. Centers for Disease Control and Prevention released a report on maternal mortality rates for 2023. While overall there was a decrease in the maternal mortality rate when compared to 2022, the rate for Black women increased slightly between 2022 and 2023, and there was a widening in the gap between White and Black women. In 2021 and 2022, the maternal death rate for Black women was roughly 2.6 times higher than that of White women, while in 2023, it was 3.5 times higher.

 

Preserving No-Cost Preventive Services 
Also last week, State Health and Value Strategies published an expert perspective that details strategies for states looking to protect access to preventive services. In light of the Supreme Court agreeing to hear Becerra v. Braidwood Management, Inc., which could substantially weaken the ACA’s guarantee of no-cost preventive services in private insurance, this new expert perspective describes how states can take action to preserve no-cost preventive services coverage in their regulated markets through legislative or administrative means. Updates follow.

 

ACA Premiums Set to Rise if Enhanced Subsidies Expire
A new interactive congressional district map from KFF illustrates how much more enrollees in ACA Marketplace plans would pay in premiums if the enhanced subsidies were to expire in 2026. The tool presents two scenarios in each district: one of an older couple who would lose subsidy eligibility due to their income exceeding four times the federal poverty level (FPL) and another for a single individual with a $31,000 income (206% FPL). The tool also presents net average premium payment increases in each district in states that use Healthcare.gov (where data are available).

 

Underinvestment in Primary Care is Impacting Patients
As the nation faces a widespread surge in chronic diseases and more people report not being able to see a clinician who knows them, the third Primary Care Scorecard by Milbank Memorial Fund highlights how systemic disinvestment in U.S. primary care is posing a grave threat to the wellbeing of communities nationwide. Milbank Memorial Fund and The Physicians Foundation will host a webinar on February 18, at 12:00 p.m. ET, on the latest national and state data on key metrics tracking the primary care workforce, financing, training, information technology, and research.

 

The National Academy for State Policy (NASHP) Hospital Cost Tool 4.0 Launch
NASHP is launching an update to the interactive Hospital Cost Tool. On February 20 at 3 p.m. ET, NASHP will host a webinar to provide an overview of the updated tool, including critical data measures, analyses of information from the tool, and how the tool may be useful in informing state policymaking. The tool provides information on a range of financial and operating measures for nearly 5,000 individual hospitals from 2011 to 2022 (soon through 2023). Users can gain insights on hospital performance calculated using hospitals’ annual Medicare Cost Reports submitted to CMS. In addition to including 2023 data, the updated tool will offer metrics on hospital prescription drug costs and charges.

 

State updates: AR, CA, CT, FL, GA, IL, MD, MN, NC, NJ, NY, RI & WI 

  • Arkansas – Governor Sarah Huckabee Sanders submitted a letter to HHS Secretary-designate, Robert F. Kennedy JR., regarding a Medicaid work requirement plan. The state also submitted a request to amend the ARHOME section 1115 demonstration to include work requirements.
  • California – The Department of Health Care Services released the Birthing Care Pathway (BCP) report, a comprehensive plan to improve maternity care for Medi-Cal members. This roadmap covers the journey of all pregnant and postpartum Medi-Cal members from conception through 12 months postpartum, aiming to make care accessible, equitable, and patient-centered. The BCP prioritizes reducing maternal mortality and morbidity, addressing health disparities, improving access and coordination, and modernizing payment models.
  • Connecticut – Governor Ned Lamont and Connecticut Consumer Protection Commissioner Bryan T. Cafferelli announced that a training program for licensed pharmacists who want to be able to prescribe contraception directly to customers is now available in Connecticut. Additionally, the state’s first vending machines providing access to emergency contraception and other over-the-counter medications are also now available.
  • Florida – CMS approved an amendment to the “Florida Managed Medical Assistance (MMA)” section 1115 demonstration. Approval of this amendment gives the state authority to (1) expand its Behavioral Health and Supportive Housing Assistance Pilot to two additional regions; (2) provide voluntary populations who enroll into MMA or the dental managed care program a choice of MMA managed care plans and dental managed care plans; (3) provide coverage of behavior analysis services through managed care instead of the fee-for-service delivery system; (4) provide coverage of non-emergency dental services provided in an ambulatory surgical center or hospital through dental managed care plans instead of MMA plans; and (5) incorporate specialty products into comprehensive managed care plans.
  • Georgia – Insurance and Safety Fire Commissioner John F. King announced that Georgia Access, the state’s official health insurance Marketplace, concluded the 2025 open enrollment period enrolling over 1.5 million consumers, including 225,000 new consumers who were not previously enrolled in coverage through HealthCare.gov.
  • Illinois – Governor JB Pritzker, the Illinois Department of Insurance, and Get Covered Illinois, the state’s official health insurance Marketplace, announced a record high 17% jump in enrollment numbers for the 2025 open enrollment period. Nearly 466,000 Illinoisans enrolled in Get Covered Illinois Marketplace plans since November 1.
  • Maryland – Governor Wes Moore announced the appointment of Dr. Meena Seshamani, former director of the Center for Medicare at CMS, as Maryland Department of Health Secretary. Pending Maryland Senate confirmation, Dr. Seshamani will assume the post as secretary on April 8. She replaces Dr. Laura Herrera Scott, who will depart on February 28.
  • Minnesota – Minnesota submitted a request for a new five-year demonstration to provide reentry services to people leaving carceral settings and expand both pre-release care planning and Medicaid eligibility and enrollment supports for people returning to the community from incarceration.
  • New Jersey – Governor Phil Murphy announced that over 20,000 New Jersey residents are set to benefit from a third round of medical debt elimination, totaling over $26 million. As a result of the state’s partnership with Undue Medical Debt, $246 million has been eliminated for 147,000 residents so far. As a reminder, SHVS published an expert perspective and a Health Affairs Forefront which track state medical debt cancellation initiatives, as well as state efforts to prevent the inclusion of medical debt on credit reports.
  • New York
    • Governor Kathy Hochul announced nearly $850 million in updated reimbursement rates for residential and day service providers licensed by the New York State Office for People With Developmental Disabilities. These resources will enable provider agencies to offer higher wages for direct care staff, which are critical to improving the quality of care for people with disabilities.
    • Governor Kathy Hochul signed legislation to enable providers who prescribe medications used to perform abortions to request that the dispensing pharmacy print the name of their practice on prescription labels instead of their personal name.
  • North Carolina
    • The North Carolina Department of Health and Human Services (NCDHHS) received approval from CMS to continue the Healthcare Access and Stabilization Program that makes hospital incentives for the state’s medical debt relief initiative possible. This new approval supports the state’s work to relieve more than $4 billion in medical debt for nearly two million North Carolinians. As a reminder, SHVS published a state spotlight on North Carolina’s medical debt relief and reform initiative.
    • NCDHHS is investing $3 million to expand access to Child First, an evidence-based, early childhood intervention program proven to reduce the risk of child maltreatment and prevent young children and families from entering the foster care system. NCDHHS is also launching a Child First Learning Collaborative to assess the program’s effectiveness, support successful implementation and help to inform the department’s future investments in evidence-based, community-based services. This initiative is part of the department’s broader $835 million investment to transform behavioral health.
  • Rhode Island
    • At the request of the Rhode Island General Assembly, HealthSource RI (HSRI), the state’s official health insurance Marketplace, released a report of key findings and recommendations of the Marketplace Coverage Affordability Work Group. The report assesses the impact of the expiration of enhanced advance premium tax credits at the end of 2025, and recommendations for creating a state-run program to provide affordability assistance through HSRI.
    • Following a significant cybersecurity incident that took the state’s single eligibility system offline for weeks, Governor Dan McKee announced that Deloitte, the system vendor, will provide the state with $5 million to cover the costs of coverage for Rhode Islanders who could not access the system to enroll in coverage.
  • Wisconsin – Governor Tony Evers announced approval of the Wisconsin Department of Health Services’ emergency rule to strengthen standards to protect more kids from further lead exposure. This change allows more kids and their families to be eligible for services to identify sources of lead exposure through an environmental investigation of the child’s home, as well as other nursing and medical follow-up actions.