January 11 Update

In This Week’s Update:

  • Extension of PHE
  • SHVS Publishes Two New Expert Perspectives
  • COVID-19 State Updates: AZ, CA, KS, MD, MA, VA, WA
  • Other State Updates: CO, DE, MN, NC, OK, TN, WA
  • Medicaid Managed Care Organization Investments in Affordable Housing
  • SIREN Conversation Series
  • Primary Care and Health Equity


Extension of PHE

As a result of the continued consequences of COVID-19, U.S. Department of Health and Human Services Secretary Alex Azar announced that he is again renewing the Public Health Emergency Declaration, effective January 21, 2021. The PHE is now set to expire on April 20, 2021 absent another renewal. State Health and Value Strategies (SHVS) has updated the resource, Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts: Effective and End Dates, to reflect the PHE renewal. The Centers for Medicare & Medicaid Services also issued new guidance for state health officials designed to drive the adoption of strategies that address the social determinants of health in Medicaid and the Children’s Health Insurance Program.


SHVS Publishes Two New Expert Perspectives

SHVS started the new year by publishing two new expert perspectives. Advancing Health Equity in Oregon: Building a Foundation is a case study of two foundational strategies employed by the state of Oregon that can serve as examples for other states seeking to further their health equity efforts. The State of Play: Public Option at the Federal and State Level and What to Expect in 2021 provides a brief overview of selected states’ efforts to implement a public option and highlights what to expect in a federal policy environment.


COVID-19 State Updates: AZ, CA, KS, MD, MA, VA, WA

  • Arizona – Gov. Doug Ducey issued an Executive Order to expand access to the COVID-19 vaccine by streamlining distribution throughout Arizona and establishing additional vaccination sites. The order directs the Arizona Department of Health Services to implement a state-directed allocation model to ensure a uniform approach to the vaccination of high-risk and high-priority Arizonans. 
  • California – Covered California, the state-based exchange, is teaming up with Black health leaders to address vaccine confidence, encourage Black Californians to get inoculated with the COVID-19 vaccine when it becomes available, and to encourage sign-ups for quality health insurance coverage through Covered California or Medi-Cal.
  • Kansas – Gov. Laura Kelly announced her administration’s final COVID-19 distribution order for population groups in Kansas. The vaccine will be administered in five phases, beginning with those most at risk of contracting or becoming seriously ill from COVID-19, which includes vaccinating those individuals who are at higher risk of exposure as a result of their job or where they live.
  • Maryland  
    • Gov. Larry Hogan announced a new special enrollment period in which all uninsured Maryland residents have the opportunity to enroll in health coverage now due to the ongoing COVID-19 pandemic and the recent rise in the positivity rate throughout the state. The enrollment period begins immediately and will run until March 15.
    • The governor also announced a series of actions to accelerate the pace of COVID-19 vaccinations in the state. These actions include using the National Guard to assist in vaccination clinics, an executive order requiring faster reporting from providers who administered the vaccine, and a “Southwest Airlines” model for rolling allocation.
  • Massachusetts – Gov. Charlie Baker signed comprehensive health care legislation that increases insurance coverage for telehealth services, expands the scope of practice for nurse practitioners, other specialized nurses, and optometrists, and takes steps to protect consumers from surprise medical bills. Recognizing the continuing impacts of COVID-19, the law also extends requirements for all insurance carriers in Massachusetts to cover COVID-19 testing and treatment. 
  • Virginia – Gov. Ralph Northam announced new actions to support the Commonwealth’s COVID-19 vaccine distribution program and accelerate the pace of vaccinations across Virginia. Among those actions includes expanding priority groups to include K-12 teachers and child care workers among the next priority group and elevating the Virginia National Guard to provide logistical support to local health departments administering vaccines.
  • Washington
    • Insurance Commissioner Mike Kreidler extended his emergency order directing all state-regulated health insurers to make additional coverage changes to aid consumers during the coronavirus pandemic. This includes a continuation of services via telehealth, coverage of medically necessary diagnostic testing for flu and other viral respiratory illnesses during a COVID-19 visit, and elimination of cost-sharing for drive-up testing sites.
    • The Department of Insurance announced that most health insurers in Washington state have signaled their intent to immediately waive all cost-sharing for COVID-19 vaccinations. Policyholders will be covered regardless of where they receive the vaccination.


Other State Updates: CO, DE, MN, NC, OK, TN, WA

  • Colorado  
    • Connect for Health Colorado, the Colorado state-based marketplace, announced that a year-over-year comparison shows Connect for Health Colorado enrollments are currently trending nine percent higher. Nearly 172,000 people so far have signed up for a health insurance plan through the state’s official marketplace, surpassing last year’s open enrollment period total of 166,850 sign ups. Residents have until Jan. 15 to sign up for coverage beginning Feb. 1.
    • The Department of Health Care Policy & Financing is expanding substance use disorder coverage for Health First Colorado (Colorado’s Medicaid program) members. Beginning Jan. 1, 2021, the Department is adding inpatient and residential components, including withdrawal management, to the continuum of outpatient substance use disorder services currently available. With these additions, the full continuum of care will be covered for eligible members.
  • Delaware – The Delaware Department of Health and Social Services announced that revenue from a new opioid impact fee created by the Delaware General Assembly in 2019 will be used to prevent overdose deaths and provide new services to those seeking treatment for their substance use disorder. Those funds will be used to bolster Delaware’s supply of naloxone; support the expansion of Bridge Clinic services to 24 hours a day in all three counties; and provide grants to people in treatment or recovery for such needs as transportation, housing, or education.
  • Minnesota – MNsure, the Minnesota state-based marketplace, reported a four percent increase in signups during this year’s OEP. From Nov. 1 to Dec. 22, 2020, more than 155,000 Minnesotans found health insurance coverage during MNsure’s eighth OEP. 
  • North Carolina
    • The North Carolina Department of Health and Human Services (NCDHHS) is partnering with North Carolina Central University’s Advanced Center for COVID-19 Related Disparities (NCCU ACCORD) to ensure comprehensive COVID-19 information is effective in reaching underserved communities in North Carolina. NCDHHS and ACCORD have partnered on a joint survey to complement the state’s existing consumer research data and support ongoing communications efforts. The data will help inform materials and outreach efforts to provide accurate and reliable information that aligns with the needs and concerns of different communities.
    • NCDHHS received approval to use federal Medicaid matching funds to expand services for the evidence-based early childhood program, Reach Out and Read. CMS approved the partnership through its Health Services Initiative that allows states to use federal matching funds to further an initiative in the state that improves the health of children, with a focus on low-income children that would be eligible for Medicaid or the Children’s Health Insurance Program.
  • Oklahoma
    • The Oklahoma Heath Care Authority (OHCA) selected Orion Health to provide support for Oklahoma’s new Health Information Exchange in an effort to improve patient care. The health information exchange is expected to launch in the fall of 2021.
    • OHCA and the Wichita and Affiliated Tribes will partner through the Money Follows the Person Tribal Initiative (MFPTI) to provide additional services for qualifying Tribal SoonerCare members. The MFPTI funding will be used to support the planning and development of an in-state Home and Community-Based Services Medicaid program tailored to American Indians/Alaska Natives who are currently in an institution.
  • Tennessee — CMS approved the state’s Section 1115 waiver to allow the state to develop a different financing structure using an “aggregate cap” approach for most of its existing demonstration alongside requests for additional flexibilities. The approval is effective for 10 years from Jan. 8, 2021 to Dec. 31, 2030.  
  • Washington – The Washington Health Benefit Exchange, the state-based marketplace, announced that more than two million Washingtonians enrolled in Washington Apple Health (Medicaid) and Qualified Health Plans. This is a new record high number of individuals and families obtaining health coverage through Washington Healthplanfinder, the online portal administered by the Exchange.


Medicaid Managed Care Organization Investments in Affordable Housing

The NORC Medicaid MCO Learning Hub is hosting a webinar on Medicaid managed care organization (MCOs) investments in affordable housing on Feb. 2. Funded by the Robert Wood Johnson Foundation, NORC’s MCO Learning Hub is committed to providing information on ways to address health equity and transform health care with a focus on MCOs, consumer groups, state Medicaid leaders, and other stakeholders. In order to help meet the growing housing and social determinants of health needs of their members, MCOs are using different approaches to grow and support their investments in affordable housing. Representatives from UnitedHealthcare, CVS Health, and CareSource will discuss their housing investment goals, funding strategies, and community partnerships for providing support to affordable housing residents. The presentations will be followed by a facilitated discussion and Q&A with the audience. 


Social Interventions Research and Evaluation Network Conversation Series

The Social Interventions Research and Evaluation Network (SIREN) at USCF has launched a biweekly series of 30-minute conversations between experts in social interventions research, practice, and policy, SIREN Coffee & Science. The events will be organized around the National Academies of Sciences, Engineering, and Medicine’s “Five As Framework,” which defines roles that health care organizations can play in integrating social care. For more on what each of the five “As” means and why SIREN adopted this organizing framework for the series, listen to the introductory podcast episode. The first conversation is Jan. 22. You can also listen to the conversations on demand at any time by subscribing to SIREN’s new podcast channel.


Primary Care and Health Equity

The Center for Health Care Strategies is launching a 15-month technical assistance opportunity focused on advancing health equity through comprehensive primary care strategies. This new initiative will support up to four states that are looking to promote health equity in risk-based Medicaid managed care programs, with a specific focus on addressing racial and ethnic disparities. Participating states will receive one-on-one technical assistance to help advance their equity goals and benefit from peer learning opportunities. Technical assistance will support states by: (1) helping identify and develop approaches to promote health equity; (2) providing examples of how other states have implemented health equity initiatives; and (3) collaborating with states to identify program design considerations and overcome challenges. Applications are due by Jan. 29, 2021 at 5 p.m. EST.