In This Week’s Update:
- Preventing millions of children from losing Medicaid coverage
- CMS RFI: health care access
- CMS clarifies parameters for covering COVID-19 vaccines
- Medicaid churn learning collaborative
- State updates: CA, CT, LA, NY, NV, NC, OK & PA
Millions of Children May Lose Medicaid: What Can Be Done to Help Prevent Them From Becoming Uninsured?
About half of children in the United States (40 million) are now insured through Medicaid or the Children’s Health Insurance Program (CHIP). These children have had stability in their Medicaid coverage during the COVID-19 public health emergency due to the continuous coverage requirement. As this requirement ends, states will have to redetermine eligibility for everyone enrolled in Medicaid, including children. A new research report from Georgetown University’s Center for Children and Families estimates that during this unprecedented event, at least 6.7 million children are likely to lose their Medicaid coverage and are at considerable risk for becoming uninsured for some period of time. The report provides key findings in states where children are at high risk of losing their health insurance and highlights issues to consider as children transition from Medicaid to another source of coverage, such as a separate CHIP program, a state or federal marketplace, or other insurance sources.
CMS RFI: Health Care Access
CMS released a request for information (RFI) seeking feedback on topics related to health care access. The RFI will aid in CMS’ understanding of enrollees’ barriers to enrolling in and maintaining coverage and accessing needed health care services and support through Medicaid and CHIP.
CMS Clarifies the Parameters for Covering COVID-19 Vaccines Under Medicaid and CHIP
CMS released an updated COVID-19 Vaccine Toolkit for Medicaid and CHIP, the first such update since May of last year. In addition to summarizing CMS’s recent vaccine-related guidance (e.g., offering monetary incentives for enrollees to get vaccinated), the revised toolkit flags two issues that may require state action to ensure compliance with federal requirements. First, states should verify that their vaccine coverage policies accommodate the potential need for one or more booster shots, consistent with FDA’s vaccine approvals and Emergency Use Authorizations. Second, states are required to provide Medicaid coverage for COVID‑19 vaccines administered by any class of health care provider so authorized under HHS’s federal PREP Act declarations, even if vaccine administration is not normally part of the provider’s scope of practice under state law.
Stabilizing Medicaid Coverage Learning Collaborative
Benefits Data Trust (BDT) is launching a new 12-month learning collaborative, with support from the Robert Wood Johnson Foundation. The collaborative will provide a unique opportunity for state Medicaid agencies to receive individually tailored technical assistance to develop and advance policies and practices that reduce Medicaid churn—the cycling of individuals on and off Medicaid. The technical assistance provided through this opportunity—at no cost to states—will support states as they prepare for the end of the Medicaid continuous coverage requirement.
- California – Covered California’s Board of Directors announced the appointment of Jessica Altman as its new Chief Executive Officer. Altman currently serves as the insurance commissioner for the Pennsylvania Insurance Department. She will join Covered California having played key roles in the Obama administration during the early implementation of the ACA, and as the chair of the Pennsylvania Health Insurance Exchange Authority, where she led the establishment of Pennsylvania’s state-based marketplace.
- Connecticut – Access Health CT, the state’s official health insurance marketplace, announced a special enrollment period for the Covered Connecticut Program, which provides health insurance at no cost to Connecticut residents who meet eligibility requirements. The Covered Connecticut Program pays the customer’s portion of the monthly premium directly to their insurance company. The program also covers the cost-sharing amounts they would typically have to pay with a health insurance plan, such as co-pays, co-insurance, deductibles, and maximum out-of-pocket costs. This special enrollment period runs now through June 30, and coverage begins on the first of the month following enrollment.
- Lousiana – The Louisiana Department of Health announced its intent to contract with five MCOs after completing a review of proposals. Contract awards are not final until the completion of the 14-day protest period and the resolution of any protests. The 14-day period begins on February 12, 2022, and ends on February 25, 2022.
- New York – NY State of Health, the official health insurance marketplace, announced that enrollment assisters will be available throughout February and March at several COVID-19 vaccination clinics to answer questions about health coverage and provide free enrollment help. These clinics will be established in areas where vaccination rates are low and the uninsured rate is higher than other parts of the state, especially in communities of color. Consumers must enroll in a health plan through NY State of Health by March 15 for coverage starting April 1.
- Nevada – The Nevada Department of Human Services is proposing changes to the state Medicaid alternative benefits plan, allowing community health workers, doula, and licensed pharmacist services. The change is expected to become effective July 1, 2022
- North Carolina – The North Carolina Department of Health and Human Services, in partnership with North Carolina’s historically Black colleges and universities, is hosting a mental health summit to assess the mental health needs of minority students on campus and the effects of the impacts from the COVID-19 pandemic. The summit, Peeling Back the Layers on Minority Mental Health, will be held on Wednesday, February 23, from noon to 3 p.m.
- Oklahoma – SoonerCare, the state’s Medicaid program, hosted three virtual town hall meetings on February 18 to provide enrollees and their family members with the opportunity to shared feedback with the Oklahoma Health Care Authority on improving healthcare. Members were able to ask questions and participate in discussions and polls on topics related to tobacco use, obesity, teen pregnancy, and other social determinants of health such as living and work conditions.
- Pennsylvania – The Wolf administration established a doula care pilot program to support individuals who are pregnant while incarcerated at the State Correctional Institution (SCI) Muncy. Funded through the Tuttleman Foundation, the doula pilot at SCI Muncy is a first step in expanding pregnancy and parenting supports for individuals incarcerated in Department of Corrections facilities.