February 24 Update

In This Week’s Update:

  • New SHVS Resource on Public Charge
  • State Updates: CA, ID, NJ, NY, PA & RI
  • New SHVS Webinar: Medicaid’s Role in Maternal Mortality
  • Risks and Challenges of Adopting a State-Based Marketplace
  • Successful Partnerships for Integrating Care
  • Rural Hospital Closures


New SHVS Resource on Public Charge

The Department of Homeland Security today will begin implementing the revised public charge rule, which has implications for state health programs and consumers. State Health and Value Strategies (SHVS) has created a resource page on its website where you can find all of its materials related to public charge, including new talking points for state health officials to use for communicating the changes to public charge to consumers. SHVS will continue to update the page with new resources and to account for any developments resulting from litigation of the rule. If your state has developed materials to educate consumers about public charge, and you are willing to share them with other states, please let SHVS know and it can post a link to them on its resource page.


State Updates: CA, ID, NJ, NY, PA & RI

  • California – Covered California, the state’s official health insurance marketplace, announced a 41 percent increase in enrollment of individuals who had newly selected a health plan for 2020 during the most recent OEP. The state attributed the increase to new state policies, which provided additional money to help people purchase health insurance and established a state penalty. The marketplace also announced a special enrollment period through April 30 to allow those who were unaware of the state penalty or the new financial help to sign up for coverage.
  • Idaho – Governor Brad Little, all five Idaho Supreme Court Justices, and legislators gathered to sign documents establishing and supporting the Idaho Behavioral Health Council, a three-branch approach to improve care for Idahoans with mental health and substance use disorders. The 13-member council will work collaboratively with local government and community partners to develop a statewide strategic plan to improve access to care.
  • New Jersey – Governor Phil Murphy announced new initiatives through schools and institutions of higher education to support youth mental health. The Department of Human Services will work in partnership with the National Council of Behavioral Health to conduct statewide Mental Health First Aid trainings for school personnel from K-12 and higher education institutions and the Department of Education will lead a statewide youth mental health working group.
  • New York – NY State of Health, the state’s official health insurance marketplace, announced that more than one in four New Yorkers signed up for health coverage during this year’s OEP. With an increase of 150,000 people over 2019, enrollment is at a record level, including more than 1 million people enrolled in Qualified Health Plans and the Essential Plan. The state reached a historic low in its uninsured rate at 4.7 percent.
  • Pennsylvania – Pennsylvania officially submitted its Section 1332 waiver application for a state reinsurance program to CMS. If approved, Pennsylvania would become the first state to pay for its share of a reinsurance waiver with savings from transitioning to a state-based marketplace. As a reminder, SHVS has a map tracking the latest state activity and a number of resources, including an application template and a checklist for states considering developing a reinsurance waiver.
  • Rhode Island – HealthSource RI, the state’s official health insurance marketplace, released the latest data from its most recent OEP. Individual and family enrollments increased this year, with nearly 43 percent of new 2020 customers being “young invincibles” age 18 to 34, up from 29 percent in HealthSource RI’s renewing population. Customers also took advantage of new customer service tools, including a new webchat service and a search tool that lists which prescription medications are covered by each health insurance plan.


New SHVS Webinar: Medicaid’s Role in Maternal Mortality

Wednesday, March 11, 2020, 3:00 to 4:00 p.m. ET

The United States is the only developed country where the maternal mortality rate has been steadily rising. Black and American Indian/Alaska Native women in the United States are 3.3 and 2.5 times, respectively, more likely to die from pregnancy-related causes than non-Hispanic white women. Medicaid has a crucial role to play in developing solutions: nearly half of all U.S. births are financed by Medicaid. On March 11, SHVS will host a webinar in which experts from Manatt Health will explore Medicaid strategies to improve maternal health outcomes and address disparities in five key domains: coverage, enrollment, benefits, models of care, and quality improvement.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e1165d3695d1bc962035f056ccff7c7e2


Risks and Challenges of Adopting a State-Based Marketplace

The Center on Budget and Policy Priorities published a report that highlights the risk and challenges states face in creating a state-based marketplace. The report encourages states to weigh the decision of whether to move to an SBM within the framework of their larger plan to increase coverage and evaluate the benefits and costs of the SBM model. To help states evaluate whether an SBM is the right fit for them, the report lays out seven recommendations for states to consider, including matching the federal facilitated marketplace’s user experience in the move to an SBM.


Effective Partnerships between Physical and Behavioral Health Organizations in Medicaid

The Center for Health Care Strategies (CHCS) released a new issue brief that identifies the key elements that contribute to successful partnerships between physical and behavioral health plans and providers to support integrated care in Medicaid. The issue brief synthesizes insights from leaders representing partnerships in Arizona, Arkansas, Colorado, and Oregon. The key elements identified by CHCS include (1) employing joint-ownership models representing both physical and behavioral health; (2) ensuring stable system transitions for consumers and providers; (3) marrying the expertise of physical and behavioral health partners to create new and enhanced capacities; and (4) allowing adequate time for planning and implementation.


Rural Hospital Closures

The Chartis Center for Rural Health published a report that examines rural hospital closures and details a model developed by the Center that estimates rural hospital vulnerability. Since 2010, 120 rural health facilities across the nation have closed and calendar year 2019 was the single worst year of the closure crisis with 19 rural hospitals shutting their doors. The Center’s analysis of a series of financial and operational metrics for closed hospitals revealed a rapid decline in performance in the 12 months prior to closure and they have used those findings to develop a model to identify the probability of closure for the nation’s 1,844 open rural hospitals.