January 29 Update

In This Week’s Update:

  • Historic levels of Marketplace Enrollment
  • Disability Data Collection Standards  
  • Easing the burden of Medical Debt
  • CMS: Funding for School-Based Health Services 
  • Executive Actions to Promote Safe Storage of Firearms
  • State updates: FL, MA, MI, MT, NC, NH, NJ, NY, PA, RI & WI


Historic levels of Marketplace Enrollment 

Last week, the Biden-Harris administration announced historic levels of enrollment in the Affordable Care Act Marketplaces, with 21.3 million people selecting a plan during the 2024 open enrollment period. Total plan selections include more than 5 million people who are new to the Marketplaces and 16 million people who have renewed their coverage. State-Based Marketplaces are also reporting record levels of enrollment, including Colorado, Maine, Maryland, Minnesota, Nevada and Washington. We will continue to highlight these gains as more State-Based Marketplaces publish their final enrollment figures.


Disability Data Collection Standards

Also last week, State Health & Value Strategies published a new issue brief on the collection of self-reported disability data in Medicaid applications. Very little is known about those who self-identify as having a disability within the Medicaid program, but who are not part of the group that qualifies for benefits through a disability-related eligibility category. This issue brief provides an overview of current disability data collection standards and documents how states are collecting self-reported disability information on their Medicaid application.


Easing the Burden of Medical Debt

Last week, Heather Howard released a new episode of her podcast, the Princeton Pulse, which delves into the underlying drivers of medical debt with Noam Levey, senior correspondent for KFF Health News, who has reported on this topic extensively, and Eva Stahl, Vice President of Public Policy at RIP Medical Debt, a nonprofit dedicated to strengthening communities by abolishing medical debt. The episode spotlights the stories of those grappling with medical debt, the inequitable impact, and policy solutions similar to the medical debt relief program in New York City that was just announced.


CMS: Funding for School-Based Health Services 

CMS announced $50 million in grants for states to connect more children to critical healthcare services, particularly for mental health, at school. Made possible by the Bipartisan Safer Communities Act, the grants will provide 20 states up to $2.5 million each in funding. Schools are uniquely positioned to help increase health equity and provide a unique opportunity to: enroll eligible children and adolescents in Medicaid and CHIP; deliver covered services, including behavioral health services to eligible children; and help children who are enrolled in Medicaid or CHIP access the services they need. Through the Notice of Funding Opportunity, CMS will fund recipient states to implement, enhance, or expand the provision of assistance through school-based entities under Medicaid and CHIP. 


Executive Actions to Promote Safe Storage of Firearms

The Biden-Harris administration announced three new executive actions to help promote safe storage of firearms. The executive actions aim to implement President Biden’s Executive Order on promoting safe gun storage in order to reduce gun violence. The U.S. Department of Education will send a letter to school principals explaining the importance of safe storage and encouraging them to communicate with their communities about how safe storage can protect students, and will also issue a new communications template that school leaders can use to engage with parents and families about the importance of safe firearm storage. Finally, the U.S. Department of Justice will release a guide to safe storage of firearms, including information on different types of storage devices and best practices. As a reminder, Heather Howard’s podcast, the Princeton Pulse, previously discussed a public health approach focused on firearm safety and injury prevention, emphasizing the value of scientific data and the implementation of evidence-informed interventions. 


State updates: FL, MA, MI, MT, NC, NH, NJ, NY, PA, RI & WI 

  • Florida – The Florida Agency for Health Care Administration announced that it will submit a request for the “Children’s Health Insurance Program Eligibility Extension,” to increase the income eligibility limit for CHIP eligibility to 300% of the federal poverty level, up from 200%. This expansion would include premiums. The public comment period will be open through February 21.
  • Massachusetts – The Healey-Driscoll Administration laid out its plan for Advancing Health Equity in Massachusetts (AHEM), an initiative to eliminate racial, economic, and regional disparities in health outcomes. Led by Secretary of Health and Human Services Kate Walsh and Undersecretary for Health Dr. Kiame Mahaniah, the initiative will engage agencies and stakeholders from across the state in reworking the systems that lead to poor outcomes for under resourced communities. The first year of AHEM will focus on maternal health and social determinants of health.
  • Michigan 
    • The Michigan Department of Health and Human Services (MDHHS) is requesting proposals to expand the Child and Adolescent Health Center Program through school-based or school-linked health services. The models funded through this grant include Child and Adolescent Health Centers (CAHC) and School Wellness Programs (SWP). Clinical CAHC and SWP program models assist eligible children and adolescents with enrollment in Medicaid and provide access to Medicaid preventive services.
    • MDHHS is requesting proposals to increase support for pregnant and postpartum people impacted by substance-use disorder by placing peer navigators in healthcare or behavioral health settings. Peer navigators support families in their recovery journey, while also helping families get connected to resources within the community.
  • Montana – Governor Greg Gianforte announced an investment of up to $8 million to improve community-based response services for individuals experiencing a behavioral health crisis. As recommended by the Behavioral Health System for Future Generations Commission, the investment is the second allocation of $300 million in funding that the governor earmarked last year for Montana’s behavioral health and developmental disabilities services systems.
  • New Hampshire – The New Hampshire Department of Health and Human Services (DHHS) announced statewide availability of the new overdose reversal medication nalmefene. Like naloxone, nalmefene is an opioid reversal medication that can be used to prevent opioid overdose deaths. DHHS has issued a standing order to all pharmacies across the state to dispense nalmefene to individuals at risk of experiencing an opioid overdose and to their family members, friends, or other people who may be able to assist at-risk individuals. Nalmefene is available at no cost to New Hampshire Medicaid enrollees.
  • New Jersey
    • Governor Phil Murphy signed S-4119/A-5739, which ensures every birthing individual has the right to a doula in a hospital or birth center. Under the bill, hospitals and birthing centers must develop and maintain policies that allow doulas to accompany patients before, during, and after labor and childbirth. These facilities will also be required to publicly post their policies and designate a contact to maintain communications between their staff, the doula community, and patients.
    • First Lady Tammy Murphy announced the launch of a new statewide universal newborn nurse home visitation program, Family Connects NJ, in select counties. The program connects new parents with a specially-trained nurse for a personalized follow-up visit at home within two weeks of their child’s birth. These visits are available to all New Jersey families at no cost, regardless of income, insurance or immigration status. 
  • New York – The New York State Department of Health is requesting to amend the 1115 Medicaid Redesign Team Waiver to allow for continuous eligibility for children up to the age of six. 
  • North Carolina
    • The North Carolina Department of Health and Human Services (NCDHHS) commissioned a study by the North Carolina Area Health Education Centers to make recommendations to enhance the direct care workforce. The report provides recommendations to enhance the workforce and NCDHHS announced funding to support rates paid to direct support professionals.
    • NCDHHS announced the release of a report on the state’s caregiving workforce. The report focuses on nursing, behavioral health and direct care professionals as the greatest areas of need and offers a roadmap of initiatives to strengthen and support the healthcare workforce.
  • Pennsylvania 
    • Pennsylvania Department of Human Services (DHS) Secretary Dr. Val Arkoosh announced the launch of PA Navigate, an online tool that connects Pennsylvanians with community-based organizations, county and state agencies, and healthcare providers for referrals to community resources that help them meet their most basic needs like food, shelter, and transportation. PA Navigate also allows individuals to refer themselves for services and facilitates greater connection and communication between healthcare providers and organizations that serve shared populations.
    • DHS Secretary Dr. Arkoosh announced the grantees that will administer the new Women’s Service Program, a grant intended to advance accessible and inclusive women’s healthcare, especially for pregnant and parenting individuals. The program will expand access to comprehensive, evidence-based care, support, and education. 
  • Rhode Island – Governor Dan McKee and the Rhode Island Executive Office of Health & Human Services announced that CMS has approved new state-directed payments (SDPs) to hospitals to promote access and quality. A SDP is a mechanism used by state Medicaid programs to direct specific payments to Medicaid providers through contracted managed care organizations. The new payments are projected to result in over $110 million in new Medicaid funding to Rhode Island hospitals. 
  • Wisconsin – Governor Tony Evers announced that the Wisconsin Department of Health Services has issued a standing order to ensure BadgerCare Plus members have direct access to over-the-counter (OTC) emergency contraception. The order allows BadgerCare Plus members to get OTC emergency contraception from any Wisconsin Medicaid-enrolled pharmacy under their state coverage without a prescription from their doctor and with no out-of-pocket cost to them.