February 8 Update

In This Week’s Update:

  • COVID-19 Vaccine Distribution
  • Communications Tactics for State-based Marketplaces
  • COVID-19 State Updates: AL, DC, MA, MN, NC, NJ, NV, OR, PA, RI, UT
  • Other State Updates: AK, AZ, NE, NJ, NM, NY, OR, PA, WI
  • New Executive Orders and Public Charge
  • Medicaid Outreach Partnership
  • Coverage for Pregnant and Postpartum Women


COVID-19 Vaccine Distribution

Last week, the Centers for Disease Control and Prevention published the first national look at demographic characteristics of persons vaccinated against COVID-19, including by race and ethnicity. State Health and Value Strategies (SHVS) has updated its expert perspective that reports on what data states are currently publicly reporting related to vaccine administration, as several states are now publishing data on vaccine distribution by race and ethnicity. SHVS will continue to update this expert perspective as states expand reporting of disaggregated data.

Communications Tactics for State-based Marketplaces

SHVS published an expert perspective last week that highlights the marketing and communications tactics state-based marketplaces employed during the 2021 open enrollment period, many of which can serve as examples moving forward to engage and enroll consumers in health coverage during the new Special Enrollment Period.


COVID-19 State Updates: AL, DC, MA, MN, NC, NJ, NV, OR, PA, RI, UT

  • Alabama – The  Alabama Department of Public Health’s Immunization Division is accepting proposals to provide COVID-19 vaccine activities for high-risk and underserved communities. The purpose of the request for proposals is to support broad-based distribution access and COVID-19 vaccine coverage for populations including racial and ethnic minority populations and rural communities.
  • Nevada – Gov. Steve Sisolak released a video message announcing a new Equity and Fairness Initiative aimed at ensuring that equity is a cornerstone of all vaccination efforts. Under this initiative, the state will work with Clark County Emergency Management and the Southern Nevada Health District to clarify prioritization lanes, support fair access to vaccines through site selection, and create equitable allocation across communities.
  • New Jersey – As part of a virtual Town Hall series on the COVID-19 vaccine, the New Jersey Department of Health is hosting a free public conversation on Feb. 11 led by medical professionals from the state’s Black and Caribbean communities who will address facts, fears, and myths regarding the COVID-19 vaccines. The Department will host a similar forum led by medical professionals from the state’s Latino communities on Feb. 15.
  • North Carolina – The North Carolina Department of Health and Human Services released new tools to help North Carolinians get their COVID-19 vaccine questions answered and to find vaccine locations in the state, including a new hotline for consumers to get up to date information as well as a new website to help individuals find nearby vaccine locations.
  • Oregon – The state is requiring health benefit plans in Oregon to cover costs of vaccination for COVID-19 following an order by state Public Health Director Rachael Banks. The order mandates that private health plans operating in Oregon not charge patients for most costs related to providing the vaccine. That includes the cost of all doses of the vaccine and associated supplies, and expenses for administering the shot, such as those related to staff time.
  • Utah – The Utah Department of Health is reminding residents that free, rapid antigen testing is still being offered by the Utah Department of Health at many locations throughout the state. New sites are targeted each week based on high positivity rates, fewer tests conducted, untreated wastewater sampling, and other surveillance data.
  • District of ColumbiaMassachusettsMinnesotaNevadaPennsylvaniaRhode Island – These states announced or extended their respective enrollment periods to provide residents affected by the COVID-19 pandemic the opportunity to enroll in coverage, mirroring recent action by the Biden administration.


Other State Updates: AK, AZ, NE, NJ, NM, NY, OR, PA, WI

  • Alaska – Healthy Alaskans, a joint initiative of the Alaska Department of Health and Social Services and the Alaska Native Tribal Health Consortium, released data showing that Alaska has met its target for or improved on 12 of its 25 health goals. The updated all Alaskan Scorecard for 2020 can be viewed at www.healthyalaskans.org. In addition, Healthy Alaskans announced that the state health improvement plan, Healthy Alaskans 2030, is now finalized and available on its website.
  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) awarded a three-year contract to Arizona Behavioral Health Corporation to administer its AHCCCS Housing Program, which consists of permanent supportive housing and housing support programs for individuals with mental health issues who are experiencing homelessness. The contract period is Oct. 1, 2021 through Sept. 30, 2024.
  • Nebraska – The Nebraska Department of Health and Human Services is asking for feedback on its draft Statewide Transition Plan for its four approved Medicaid home- and community-based services waivers that provide services to individuals in the community. The public comment period runs from Feb. 1, 2021 to March 2, 2021.
  • New Jersey
    • First Lady Tammy Murphy and Human Services Acting Commissioner Sarah Adelman announced the state Medicaid program now covers doula care, while also no longer paying for nonmedical early elective deliveries. The Medicaid program will also require obstetrical providers, nurse midwives, or other licensed health care professionals to complete a perinatal risk assessment form during an enrollee’s first prenatal visit to help identify trends in risk factors.
    • Governor Phil Murphy and Department of Children and Families Commissioner Christine Norbut Beyer launched New Jersey’s first Adverse Childhood Experiences (ACEs) Action Plan, a comprehensive statewide strategy to prevent and reduce childhood trauma and adversity. The action plan outlines several initiatives to identify, coordinate, and advance programs and services across state government to reduce and prevent ACEs that negatively impact the developing brain and lead to lifelong social, physical, emotional, and economic challenges.
  • New Mexico – BeWellnm, the New Mexico state-based marketplace, awarded its outreach and education contract to the Albuquerque Hispano Chamber of Commerce (Hispano). Hispano is a nonprofit, member-based organization focused on improving economic development, education, and job training in New Mexico. The partnership between beWellnm and Hispano will increase awareness among New Mexicans about individual, family, and small business health care coverage options.
  • New York – NY State of Health, the New York state-based marketplace, released a new Outreach Took Kit, which includes resources for certified assistors who enroll New Yorkers into health coverage, as well as for partner organizations that share information about NY State of Health and encourage New Yorkers to enroll. The page will be updated throughout the year to reflect key information New Yorkers need to know about enrolling. 
  • Oregon  
    • The Oregon Health Authority (OHA) announced the first minimum spending floor for hospital community benefits on Feb. 1. Each tax-exempt hospital or hospital system in the state will receive a floor for community benefit spending based on its revenues, prior expenditures, financial health, and the needs of the population served. 
    • OHA released its biennial Oregon Health Care Workforce Needs Assessment report, which shows that the racial/ethnic diversity of the health care workforce does not match the diversity of the Oregon population, with Hispanic/Latino, African American/Black, and American Indian/Alaska Native providers underrepresented in most licensed health care professions. At the same time, OHA released its evaluation of the Health Care Provider Incentive Program, which shows how Oregon’s incentive programs are performing in addressing workforce challenges.
  • Pennsylvania – Pennie, the Pennsylvania state-based marketplace, announced that by the end of its inaugural open enrollment period nearly 338,000 Pennsylvanians enrolled in coverage, a more than 5,000 person increase over last year. Over 75,000 new customers enrolled in coverage through Pennie, a 9.7 percent year-over-year increase.
  • Wisconsin – Beginning Feb. 1, Wisconsin is covering the treatment for substance use disorder in a residential setting for members of most of its Medicaid programs. The treatment offered uses a “whole patient” approach that is clinically effective, reduces overdoses and deaths, and helps people sustain recovery. Health care providers will determine whether their patients require this level of care using criteria from the American Society of Addiction Medicine. The new benefit is offered under a Section 1115 waiver from the Centers for Medicare and Medicaid Services to cover treatment in larger treatment facilities.


Immigration Executive Orders Set Stage for Administration to Revisit Public Charge Rules

President Biden issued three Executive Orders (EOs) last week that outline his administration’s vision for immigration policy. One Executive Order, Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans, directs the Departments of Homeland Security, State, and Justice to review rules and agency actions related to the public charge grounds of inadmissibility. The order further directs the agencies to take steps to address concerns about how the current rules impact the immigration system and public health, including by recommending steps that agencies (including the Department of Health and Human Services) should take to clearly communicate current public charge policies and proposed changes, if any, to reduce the fear and confusion that has led to a “chilling effect” and driven many individuals—including those who are not impacted by the current rules—away from public benefits. The broad language in the EO directing the agencies to review policies and report (within 60 days) on next steps to address them preserves the ability for the impacted agencies to work with the Department of Justice to consider litigation strategy in pending cases, being the rule-making process to rescind the rules, or both.


Medicaid Outreach Partnership

Recent years have seen a decline in Medicaid enrollment, and the impact of COVID-19 has left many people without coverage and unaware of affordable options. Funded by the Robert Wood Johnson Foundation and led by Community Catalyst, the Medicaid Outreach Partnership brings together leading national organizations and their state-based partners to reach and enroll individuals and families in Medicaid and the Children’s Health Insurance Program (CHIP). This new website provides resources that state and local community partners can use to increase Medicaid outreach and enrollment efforts nationwide and in specific states including Michigan, New Jersey, Florida, and Texas. While this initiative currently provides tailored support to specific organizations and their affiliates in the four targeted states, there are a wide array of resources available to support Medicaid outreach and enrollment work happening across the country and in different communities. The website provides a message guide, communications toolkit, and many choices of flyers and social media graphics. There are also ready-to-download versions of the flyers featuring state-based Medicaid information for all 50 states and the District of Columbia as well as a host of general social media graphics. These materials are available under the “download” option on the Materials page. Many materials are available in a variety of languages. States can use these resources to support Medicaid outreach and enrollment efforts.  


Coverage for Pregnant and Postpartum Women

The Urban Institute released two reports on health insurance coverage for pregnant and postpartum women. The Public Health Insurance Landscape for Pregnant and Postpartum Women assesses the current public health insurance landscape for pregnant and postpartum women, including Medicaid, CHIP, and subsidized Marketplace coverage and considers recently proposed state and federal legislation to extend postpartum coverage, and the extent to which such legislation could expand the coverage landscape for new mothers. In Closing Postpartum Coverage Gaps and Improving Continuity and Affordability of Care through a Postpartum Medicaid/CHIP Extension, researchers evaluate how many uninsured new mothers would likely benefit from a 12-month postpartum Medicaid/CHIP extension. As a reminder, SHVS published an issue brief, Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis, and hosted a companion webinar that describes select policy and strategy levers that Medicaid agencies can employ to improve maternal health outcomes and address outcome disparities.