July 17 Update

In This Week’s Update:

  • State Reporting to Monitor Unwinding
  • Limiting Junk Insurance
  • Value-Based Payment for Prescription Drugs
  • Behavioral Health Services in Rural Communities
  • State updates: AR, AZ, ME, MN, MO, NC, NJ, NY & OR


State Reporting to Monitor Unwinding

Last week, State Health and Value Strategies updated their expert perspective, State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement, which features an interactive map with links to states publicly reporting unwinding data in the form of a dashboard or reports to CMS. This resource has been updated to include unwinding dashboards from Marketplaces, and new reports from states including Indiana, Massachusetts, Michigan, Oregon, South Carolina and Tennessee. SHVS will continue to update this EP as more states publish unwinding data. As a reminder, SHVS published an expert perspective that highlights best practices for publicly reporting unwinding data such as prioritizing key measures, disaggregating data and providing context.


Limiting Junk Insurance

A new Health Affairs Forefront article describes how most federal standards and state-level consumer protections that apply to individual health insurance coverage do not apply to short-term limited duration health insurance (STLDI) or hospital and fixed indemnity insurance. Issuers can deny policies to people with pre-existing conditions, set caps on benefits, and exclude from coverage critical benefits such as prescription drugs, maternity services and mental healthcare. On July 7, the Departments of Health and Human Services, Labor and Treasury published a proposal to alter federal regulation of STLDI and indemnity insurance to make it easier for consumers to enroll in and retain coverage, understand their coverage options and protect consumers from low-quality coverage. This article makes the case for revisiting STLDI and indemnity insurance policies, the proposed changes and the administration’s request for public comments on the proposed rule.


Value-Based Payment for Prescription Drugs

Prescription medication costs continue to rise, partly because of the introduction of new and costly drug therapies. While policymakers have proposed several ways to control drug costs, one promising  approach is value-based payment (VBP), which ties payment for health services to their relative cost and efficacy. An article from the Commonwealth Fund discusses the innovation of incorporating prescription drugs in VBP by addressing underuse, offering incentives for appropriate use, and providing data to inform better prescribing. While barriers do exist to design and implement VBP models for prescription drugs, the article argues that a spectrum of options should be explored.


Behavioral Health Services in Rural Communities

An upcoming webinar hosted by the National Academy for State Health Policy will address the challenges that people living in rural areas face seeking behavioral healthcare. North Dakota and Oklahoma will discuss the use of Medicaid funding to enhance behavioral health services for rural residents. Officials from each state will participate in the webinar and offer knowledge exchange and collaboration on the obstacles faced by rural communities, including workforce shortages, the need to travel longer distances to obtain care and stigma.


State updates: AR, AZ, ME, MN, MO, NC, NJ, NY & OR

  • Arizona
    • Governor Katie Hobbs announcedthe expansion of access to over-the-counter contraception to Arizonans 18 years and older without a doctor’s prescription. The standing order goes into effect immediately and patients seeking contraceptives will be required to complete a screening and blood pressure test.
    • The Arizona Health Care Cost Containment System (AHCCCS) releasedits monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began in April. In the month of June, 67% of the renewals initiated were automatically determined to be eligible to maintain AHCCCS coverage. Approximately 25% of all individuals who have been disenrolled for not responding to AHCCCS have taken advantage of the 90-day window to finish their renewal.
  • Arkansas– The Arkansas Department of Human Services released its June report on Medicaid unwinding. In June, more than 50,000 cases were renewed after eligibility was confirmed, and approximately 77,000 enrollees were disenrolled.
  • Maine– The Maine Bureau of Insurance released the 2024 proposed insurance rate filings for the individual and small group market. The proposed rate filings are currently under review.
  • Minnesota– The Minnesota Department of Human Services is sending $36 million to support county and Tribal efforts to renew Minnesotans’ health insurance. The funds will cover costs such as addressing health disparities, hiring and training staff, paying overtime and reaching out to enrollees.
  • Missouri– Governor Mike Parson signed legislation to expand postpartum Medicaid coverage from 60 days to one year. As a reminder, SHVS published an issue brief on the American Rescue Plan Act (ARP) option to extend postpartum coverage.
  • New Jersey
  • Governor Phil Murphy signeda legislative package to help make prescription drugs more affordable for New Jerseyans. The three bills will work together to cap certain out-of-pocket costs, establish greater oversight of pharmacy benefit managers, and promote transparency across the pharmaceutical supply chain.
  • Governor Murphy signeda bill expanding expenses that New Jersey’s K-12 public schools may be reimbursed for in regards to behavioral health services that are provided to students and their families who are Medicaid enrollees. With this authority, the Department of Human Services will begin seeking federal approvals for this program. Once the program is approved, the Division of Medical Assistance and Health Services will assist schools in implementing a plan to submit Medicaid claims for reimbursement.
  • New York– Governor Kathy Hochul announced that the New York State Office of Mental Health and the Office of Addiction Services and Supports have made $3.5 million available for start-up grants to develop 13 new Certified Community Behavioral Health Clinics, 24-hour centers that provide comprehensive services for those requiring behavioral health support, specifically coordination care across behavioral, physical health, and social service systems.
  • North Carolina– The North Carolina Department of Health and Human Services announced new state level data that shows the lowest rate of tobacco use in more than a decade for people in North Carolina who struggle with their mental health or heavy drinking. New data shows the percentage of behavioral health programs providing tobacco use screening and treatment to clients increased by more than 60% across substance-use and mental facilities since 2016. Between 2020 and 2021, the percentage of North Carolina substance-use disorder facilities with a smoke-free campus policy also increased 30%.
  • Oregon– The Oregon Health Authority announced that starting July 1, Oregon Health Plan (OHP) coverage is available to all children and adults who meet income and other eligibility criteria, regardless of immigration status. The change initially applies to approximately 40,000 members ages 26 to 54 who moved automatically from emergency coverage to full OHP benefits July 1. But, beginning July 1, all people who meet income and other eligibility criteria, regardless of immigration status, can enroll.