July 11 Update

In This Week’s Update:

  • New SHVS Social Care Resource
  • Implementing ‘988’
  • Expiration of ARPA subsidies
  • Post-PHE State Telehealth Policy Trends
  • State updates: CO, ME, MT, NH, NC, NV, TN & WA

How to Monitor the Implementation of Social Care

Last week, State Health and Value Strategies published findings from a series of interviews with state Medicaid leaders about how to monitor the implementation of “social care.” State Medicaid agencies are increasingly exploring opportunities to incorporate “social care” into strategies for improving health, decreasing healthcare costs, and achieving equity. The findings are derived from a two-part research project conducted by the Social Interventions Research and Evaluation Network at the University of California, San Francisco (SIREN) for SHVS that explored ways to scale and sustain social care across the healthcare sector. The first component, which conceptualizes social care performance measurement, can be found here

State Legislation to Fund and Implement ‘988’

Starting on July 16, dialing 988 will route callers nationwide to the National Suicide Prevention Lifeline. In preparation to launch this new congressionally mandated three-digit calling code, states are considering necessary components for implementation, such as telecommunications charges and funding schemas, workgroups to drive 988 policy, and how to integrate this into existing crisis call systems. A recently updated tracker by the National Academy for State Health Policy provides an overview of state enacted and introduced legislation to implement and fund 988. 

Delays Extending Health Insurance Subsidies Will Raise Premiums and Reduce Coverage

As a recent Health Affairs blog post describes, delaying legislation to extend the premium tax credit expansions from ARPA past August 2022 would likely deny many people the benefits of any would-be extension. The authors, SHVS partners Jason Levitis and Sabrina Corlette, explain that although ARPA’s expanded premium tax credit (PTC) currently runs through December, Congress’s real deadline to avert premium increases and coverage losses is August. Most consumers will make 2023 coverage decisions in 2022, and there are substantial operational runways to set insurance rates, update eligibility systems and consumer-facing language to reflect PTC parameters, and calculate enrollees’ new eligibility and notify them—all before the open enrollment period begins November 1, 2022. Delaying will also impose operational costs on Marketplaces, diverting scarce financial, communications, and IT resources from other priorities. 

Post-PHE State Telehealth Policy Trends

Telehealth has emerged as an essential tool for expanding patient access to healthcare services during the ongoing COVID-19 pandemic. States, payers, and providers are continuing to examine the evolving role telehealth will play in the years to come. In a new webinar on July 13, 1:00 p.m. ET, Manatt Health, the American Medical Association and a panel of state leaders will discuss how that long-term perspective is driving state policymaking for the use, coverage and payment of telehealth in the future. Key topics will include telehealth utilization trends, temporary state telehealth policy changes, and state trends in post-public health emergency telehealth policies. Registration information is available here

 State Updates

  • Colorado – The Department of Health Care Policy & Financing has created a toolkit to provide community partners, stakeholders, and advocates with messaging and resources to encourage Health First Colorado and Child Health Plan Plus members to update their contact information in advance of the end of the public health emergency. 
  • Maine – The Department of Health and Human Services announced that it has established MaineCare eligibility for children under 21 years of age who would be otherwise eligible for federal Medicaid benefits but are not eligible due to their immigration status and for pregnant people who are not eligible for federal Medicaid benefits due to their immigration status, but are able to receive coverage under the federal Children’s Health Insurance Program. 
  • Montana – The Department of Public Health and Human Services has launched a new behavioral health program through the Montana Tobacco Quit Line to help persons with behavioral health conditions successfully quit tobacco products. According to the 2020 Montana Behavioral Risk Factor Surveillance System, the smoking prevalence is more than two times higher among adults who reported frequent poor mental health days compared to those who did not. It is estimated that 500 Montanans will benefit from the new program over the next fiscal year.
  • New Hampshire – Governor Chris Sununu signed legislation to provide Medicaid dental coverage to 85,000 adults in the state. Funding for the first three years will come from a $21 million settlement the state reached with Centene over Medicaid pharmacy benefit management costs.
  • Nevada – The Nevada Department of Health and Human Services requests authority for a new five-year Section 1115 demonstration to expand statewide access to comprehensive behavioral health services for those with opioid use disorders and other substance use disorders. Specifically, the state seeks a limited waiver of the federal Medicaid Institutions for Mental Diseases exclusion. The federal public comment period will be open from July 5, 2022 through August 4, 2022.
  • North Carolina – The North Carolina Department of Health and Human Services announced the establishment of Community Access Points in all counties to provide free and easy COVID-19 tests for home use. Starting July 1, people will be able to find home tests at covid19.ncdhhs.gov/FindTests
  • Tennessee – CMS sent a letter to Tennessee requesting that it make changes to its proposed TennCare Section 1115 waiver, which would authorize the state’s Medicaid block grant program. For more information about the TennCare III Demonstration, SHVS published an analysis of the waiver when it was approved by CMS in 2021. 
  • Washington – CMS approved Washington state’s extension of Medicaid and CHIP coverage for 12 months after pregnancy under ARPA. As a result, up to an additional 12,000 people annually will now have access to Medicaid or CHIP coverage for a full year after pregnancy. With this approval, an estimated 265,000 Americans annually in 15 states and D.C. have gained access to 12 months of postpartum coverage through ARPA. As a reminder, SHVS published an issue brief that examines the ARPA postpartum coverage extension.