In This Week’s Update:

• Medicaid Renewal Mitigation Strategies 
• Promoting Equity in Mental Healthcare
• State Unwinding Renewal Data
• The One Year Anniversary of 988
• Preventing Intimate Partner Violence
• State updates: AK, CA, CO, CT, IA, KY, MD, MI, MN, MS, NJ, WA, WI & WY

 

Medicaid Renewal Mitigation Strategies 

Last week, CMS published a summary of the mitigation strategies 35 states adopted to comply with Medicaid renewal requirements. The summary highlights specific areas where states were deemed out of compliance with the federal renewal requirements, and states’ primary, high-level mitigation strategies. Of note, nine states paused procedural terminations as part of their mitigation plan and 16 states did not identify areas of non-compliance and therefore did not adopt mitigation strategies. In case you missed it, CMS, the Department of Treasury, and the Department of Labor jointly issued a letter this week to employers to ensure that employees and their families remain connected to health coverage during unwinding. The letter encourages employers and other plan sponsors to match steps taken by HealthCare.gov and extend the special enrollment period under their plans beyond the minimum 60-day period required by federal law for individuals who may be losing Medicaid or CHIP coverage.

 

Promoting Equity in Mental Healthcare

Also last week, State Health and Value Strategies (SHVS) published a new issue brief, Medicaid Managed Care Strategies to Reduce Racial and Ethnic Health Disparities in Mental Healthcare for Adults, which describes Medicaid’s unique position to promote greater equity in mental healthcare, as the program plays an outsized role in the financing and delivery of mental healthcare. This issue brief identifies ways in which states can leverage their Medicaid managed care programs to advance their health equity goals. 

 

State Unwinding Renewal Data

The Georgetown University’s Center for Children and Families released a new interactive chart of state unwinding renewal data. The chart shows the share of ex parte renewals in which coverage is automatically renewed for an individual based on information in the enrollee’s case file or electronic data sources and the enrollee is not required to return a form or take action to maintain Medicaid coverage. This resource also shows the share of people being disenrolled for procedural versus eligibility reasons and the share of pending cases. SHVS continues to monitor states publicly releasing unwinding data with an interactive map.

 

The One Year Anniversary of 988

One year ago, the United States transitioned to a new, three-digit nationwide number for suicide prevention and mental health crisis response services. The new hotline is intended to offer an alternative to calling 911 for a behavioral health crisis. Mobile crisis services are a core element of a comprehensive continuum of care for people experiencing a behavioral health crisis and help to ensure people obtain the right services in the appropriate location. A new SHVS expert perspective spotlights Washington’s comprehensive approach and provides a roadmap for states seeking to expand access to behavioral health crisis services.

 

Preventing Intimate Partner Violence

Intimate partner violence (IPV) is a pervasive public health issue. The prevalence and severity of IPV is known to intensify during pregnancy and carries with it a unique set of intergenerational consequences for the expectant family. Cross-sector partnerships between organizations with expertise that span the prevention continuum are a promising approach to reduce the toll of IPV on families and communities. With expertise spanning research and policy, IPV and early childhood services, and local systems change, experts from PolicyLab, Maternity Care Coalition, and The Office of Domestic Violence Strategies for the City of Philadelphia co-created an issue brief to elevate the need for a multi-sector approach to IPV prevention and examine how early childhood home visiting programs and IPV services can partner in such prevention efforts. 

 

State updates: AK, CA, CO, CT, IA, KY, MD, MI, MN, MS, NJ, WA, WI & WY

• Alaska – Governor Mike Dunleavy signed legislation extending eligibility for postpartum Medicaid coverage from 60 days to 12 months. As a reminder, SHVS published an issue brief on the American Rescue Plan Act (ARP) option to extend postpartum coverage.
• Colorado – Governor Polis and the Colorado Division of Insurance released preliminary information about the 2024 health insurance plans and premiums that insurance companies filed for the individual and small group market. The state’s reinsurance program is estimated to save $357.8 million for consumers next year, taking the total estimated savings from the program to $1.5 billion since 2020.
• Connecticut – Governor Ned Lamont has signed a series of bills to protect reproductive rights in Connecticut. The laws protect medical providers from adverse actions taken by another state; allow pharmacists to prescribe birth control; increase access to reproductive care for college students at public institutions of higher education; and protect the privacy of patient health data online.
• Iowa – As part of the Iowa Department of Health and Human Services (HHS) Community-Based Redesign Project, HHS and Mathematica have developed a survey to learn about people’s experiences with community-based Medicaid services. HHS is asking Medicaid enrollees who utilize these services, their family members, case managers and providers to complete the survey.
• Maryland – The Maryland Department of Health announced that 28,694 individuals were disenrolled from Medicaid in June: 17,075 were disenrolled for procedural reasons while 11,619 were disenrolled because they are no longer eligible for coverage. Of the 98,630 individuals whose eligibility was renewed, 53.5% had their eligibility auto-renewed.
• Michigan – The Michigan Department of Health and Human Services (MDHHS) announced that as of July 6, the state renewed Medicaid coverage for 103,540 people. That includes 30,456 renewals for enrollees who submitted their paperwork and 73,084 for people who were renewed by MDHHS because the department already had necessary information required for eligibility.
• Minnesota – The Minnesota Department of Human Services announced that efforts to reach enrollees regarding Medicaid unwinding have so far included over 92,000 text messages and 290,000 paper notices through the mail. Partners are also reaching out through direct phone calls, texts, emails and in-person contacts in some locations.
• Mississippi – The Mississippi Division of Medicaid posted the unwinding report it submitted to CMS for June 2023 and announced that approximately 56% of the enrollees in the June review month retained coverage. Of the more than 29,000 who were disenrolled, at least 60% were individuals whose coverage had previously been extended because of the special eligibility rules during the public health emergency.
• New Jersey – Governor Phil Murphy signed legislation to create the New Jersey Maternal and Infant Health Innovation Authority, which will oversee the New Jersey Maternal and Infant Health Innovation Center in Trenton. The Authority will be governed by a 15-member board which will adopt recommendations to reduce maternal mortality, morbidity and disparities from the New Jersey Maternal Care Quality Collaborative.
• Washington – CMS approved Washington’s five-year section 1115 demonstration renewal, the Medicaid Transformation Project 2.0. The demonstration includes authority to cover health-related social needs, such as nutrition and housing supports, as well as pre-release services for justice-involved individuals. The state previously took up the ARP option to provide 12 months of continuous postpartum coverage for individuals enrolled in Medicaid or CHIP while pregnant. Under the demonstration, Washington will also provide 12 months of continuous coverage to postpartum individuals who enroll in Medicaid and CHIP during the postpartum period, with incomes of up to 193% of the federal poverty level.
• Wisconsin – The Wisconsin Department of Health Services announced the selection of 90 awardees for Medicaid home and community-based services grants that will improve services for people who are older or have a disability, helping them remain in their home or community. A total award of $12.5 million to 90 organizations marks the completion of the second round of funding made possible by the ARP.
• Wyoming – The Wyoming Department of Health is reminding Medicaid enrollees, family members, providers and case managers that services provided to certain populations through waiver programs are part of Wyoming Medicaid and individuals need to return their renewal forms to avoid loss of coverage.
• California & Kentucky – CMS approved proposals from California and Kentucky for community-based mobile crisis intervention teams to provide Medicaid crisis services. This marks six states that have expanded access to community-based mental health and substance-use crisis care through the ARP. As a reminder, SHVS published an expert perspective on the enhanced payment available through the ARP for community-based mobile crisis services.