July 1 Update

In This Week’s Update:

  • CMS Funding Opportunity for SUD Treatment
  • State Updates: LA, MA, ME, MT, NE, NJ, NY, & PA
  • Individual Market Performance This Year
  • Supporting Kids’ Social and Emotional Development
  • RWJF Annual Message: Housing and Health


CMS funding opportunity for SUD treatment

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a funding opportunity for at least 10 states to receive between $2 million and $5 million in federal planning grants to increase Medicaid providers’ capacity to deliver substance use disorder (SUD) treatment and recovery services. The 18-month funding opportunity is the first component of a SUPPORT Act-required, 54-month demonstration; five of the states that receive planning grants will subsequently be selected to receive 36 months of enhanced federal matching services for certain SUD expenditures.


State Updates: LA, MA, ME, MT, NE, NJ, NY, & PA

  • Louisiana – CMS approved Louisiana’s Medicaid State Plan Amendment, which authorizes the state to negotiate supplemental rebate agreements from prescription drug manufacturers using a new “modified subscription” model that initially focuses on antiviral agents for hepatitis C and promotes eliminating the hepatitis C virus statewide.
  • Maine – Governor Janet Mills signed into law a comprehensive prescription drug reform package. The package contains a suite of proposals that would allow the wholesale importation of prescription medicine, create a prescription drug affordability board, increase drug price transparency, and better regulate pharmacy benefit managers.
  • Massachusetts – Last week, the Massachusetts Health Connector, the official state-based exchange, embarked on a one-day, multi-city tour that included stops at six locations across the Commonwealth to remind Massachusetts residents to enroll in health coverage.
  • Montana – Montana officially submitted its Section 1332 waiver application to CMS. The waiver application seeks to create a state reinsurance program for a period of five years. This update and other state activity is included in this map from State Health and Value Strategies.
  • Nebraska – The Nebraska Department of Health and Human Services announced a series of training events aimed at helping parents of children with mental health and/or substance use disorders gain the skills and knowledge to be a voice at all levels on decision-making teams, as well as advocate for their own families. There are two levels of the Parent Leadership training. Parent Leaders represent the family voice within programs, agencies, and communities and help shape the direction of policies, procedures, and services for all families.
  • New Jersey
    • The New Jersey state legislature passed legislation authorizing the state Department of Banking and Insurance to establish a state-based exchange for certain health benefits plans. The legislation now heads to the governor’s desk for signature.
    • As part of its mission to improve maternal health outcomes and racial disparities, First Lady Tammy Murphy and the Department of Health released the first New Jersey Report Card of Hospital Maternity Care, which includes interactive data on hospital-specific and statewide surgical births, complication rates and severe maternal birth complications. The public report card dashboard allows users to select a New Jersey birthing hospital and view the total number of births, methods of delivery and complication rates. It also enables users to compare rates by hospital and view statewide breakdowns by race.
  • New York – NY State of Health, the state’s official health plan Marketplace, announced its partnership with the NYS Department of Agriculture and Markets in an effort to educate shoppers at more than 20 farmers markets throughout the state about low-cost, quality health coverage. Certified Enrollment Assistors will be available at select markets to answer any questions about enrolling in a health plan through the Marketplace and to set up enrollment appointments.
  • Pennsylvania – The state legislature passed a bill authorizing the creation of a state-based exchange as well as authorization for the state to apply for a Section 1332 waiver for a state reinsurance program. The bill will head to the governor’s office to be signed into law.


Individual Market Performance in Early 2019

new Kaiser Family Foundation analysis looks at the state of the individual insurance market in the first quarter of 2019, the first in which the Affordable Care Act’s individual mandate penalty is no longer in effect. With premiums falling slightly on average in 2019, insurers have seen a decline in their margins. However, the analysis suggests that the individual insurance market remains stable and insurers are generally profitable, despite repeal of the individual mandate penalty and expansion of loosely-regulated short-term plans. The analysis draws upon financial data reported by insurance companies to the National Association of Insurance Commissioners and examines the average premiums, claims, insurer medical loss ratios and gross margins from first quarter 2011 through first quarter 2019 in the individual insurance market.


Supporting the Social and Emotional Development of Young Children Through Pediatric Care

Nearly half of children under age 3 in the United States get their health insurance through Medicaid and the Children’s Health Insurance Program (CHIP). With such broad reach, these programs can play a significant role in the delivery of pediatric health care to ensure it addresses the social and emotional health of young children. A new Blueprint, authored by Manatt Health and the Center for the Study of Social Policy (CSSP), describes a set of strategies and tools that state Medicaid and CHIP agencies, and others, can use to optimize the social and emotional development of young children through pediatric practice. The Blueprint was discussed in a webinar hosted by Manatt Health, CSSP, and the Pediatrics Supporting Parents Initiative. For more information, see How Can Medicaid and CHIP Support Children’s Emotional Health?


Robert Wood Johnson Foundation Annual Message: Focus on Housing and Health

Robert Wood Johnson Foundation (RWJF) President Richard Besser released RWJF’s annual message and highlighted housing as one important health equity issue. In a Culture of Health, everyone has an opportunity to reside in an affordable, safe, stable home and a neighborhood that fosters well-being. In this annual message, RWJF highlights housing as one key factor of thriving communities. Using an interactive webpage, the foundation features key data points and stories as examples of how housing is linked to health and equity and urges policymakers to use this information to spur change in their communities.