July 25

In This Week’s Update:

  • COVID-19 PHE Renewed
  • New Funding for Connecting Kids to Coverage 
  • Transitions to Exchange Coverage
  • Medi-Cal and Health Equity for Pregnant People
  • State Updates: CA, GA, MA, ME, MI, MT, NE, OR, TN & WA


COVID-19 PHE Extended 90 Days 

On July 15, HHS announced the renewal of the federal COVID-19 public health emergency (PHE). As a result, the PHE remains in effect for an additional 90 days through October 12, 2022. SHVS updated our resource, Federal Declarations and Flexibilities Supporting Medicaid and CHIP COVID-19 Response Efforts Effective and End Dates, which summarizes the timeframes for emergency measures tied to the PHE, including the effective dates and expiration timelines. SHVS also published an expert perspective that identifies strategies for state-based marketplaces—in partnership with Medicaid agencies, departments of insurance, consumer assisters, and participating insurers—to help maintain continuity of care when the PHE ends.


New Funding for Connecting Kids to Coverage 

CMS also announced the award of $49 million to support outreach and enrollment through the Connecting Kids to Coverage Program. CMS issued 36 cooperative agreements in 20 states to grantees who will each receive up to $1.5 million over three years to advance Medicaid and CHIP enrollment and retention. As a reminder, SHVS has created a one-stop resource page of communication materials to support state’s communication efforts in preparation for the end of the PHE. 


Transitions Between Medicaid, CHIP, and Exchange Coverage in 2018

A new report by the Medicaid and CHIP Payment and Access Commission (MACPAC) looks at transitions between insurance programs in 2018. The MACPAC report finds that overall, only about 3% of all adult and child enrollees who were disenrolled from Medicaid and the Children’s Health Insurance Program (CHIP) enrolled in exchange coverage within a year after disenrolling, lower than previous estimates. Most individuals who moved from Medicaid to the exchange had a gap in coverage, and the brief discusses policy approaches to help reduce those coverage gaps. These issues have received renewed attention as states make plans for conducting Medicaid redeterminations at the end of the PHE, since many enrollees who are expected to lose Medicaid coverage may be eligible for exchange coverage.


California’s Medi-Cal Program Aims to Advance Health Equity for Pregnant People

Medicaid programs collectively are the largest insurer of births in the United States, covering 42% of all births. California’s Medicaid program, Medi-Cal, pays for more than 50% of births in the state. That’s nearly 5%  of all births in the United States, and over 11% of all Medicaid births nationally. With new budget initiatives, a California Momnibus Act, and a new Medicaid transformation initiative called California Advancing and Innovating Medi-Cal, California is seeking to advance more whole-person care for pregnant and birthing people and to ensure and expand access to reproductive healthcare. This Center for Health Care Strategies Policy Cheat Sheet explores what these new initiatives mean for maternity and reproductive healthcare in California and why other states may want to pay attention. 


Rural Maternal Health Networks: Evaluation Findings

The Rural Maternity and Obstetrics Management Strategies (RMOMS) program promotes network models to increase access to pregnancy-related care in rural communities. On August 1, the Rural Health Information Hub will host a webinar discussing lessons learned from the planning and first implementation years of the three networks awarded funding in 2019: the Missouri Bootheel Perinatal Network, the New Mexico Rural Obstetrics Access and Maternal Services Network, and the Texas-RMOMS Comprehensive Maternal Care Network. Registration is available here.


State Updates 

  • California
    • The Department of Health Care Services released a request for information (RFI) seeking an experienced communications/advertising vendor to implement a broad and targeted education and outreach communications campaign for Medi-Cal (Medicaid) enrollees during and after the end of the COVID-19 PHE. Responses are due by August 19, 2022.
    • Covered California, the state’s official health insurance marketplace, announced its plans and rates for the 2023 coverage year. The preliminary weighted average rate change is an increase of 6%, due in part to the potential end of the financial help offered to eligible consumers through the American Rescue Plan Act, if Congress does not extend the law before it expires at the end of the year.
  • Georgia – The Georgia Department of Community Health announced CMS renewed its Section 1915(c) Comprehensive Supports Waiver for individuals with intellectual and/or developmental disabilities for five years effective April 1, 2021. The waiver provides home and community-based services (HCBS), including community living support, adult dental, adult occupational and physical therapy, adult speech and language therapy, and nursing services. 
  • Maine – Governor Janet Mills announced that CMS has approved Maine’s application for its Section 1332 waiver for a reinsurance program, which will improve health insurance for small businesses by implementing innovations to help increase coverage and hold down premium increases.
  • Massachusetts – The Massachusetts Executive Office of Health and Human Services released a request for responses for the state’s Behavioral Health (BH) and Long Term Services and Supports (LTSS) Community Partners program. Under the program, Medicaid accountable care organizations and Medicaid managed care plans will be required to contract with community partners selected by the state for care coordination for enrollees that have predominant BH and/or LTSS needs.
  • Michigan – The Michigan Department of Health and Human Services announced that medical providers of behavioral health services in under-resourced areas in Michigan are now eligible for medical education loan repayment through the MI Kids Now Loan Repayment Program. The program is open to providers of services to both children and adults, but the priority will be providing debt relief to those who serve children.
  • Montana – The Department of Public Health and Human Services announced that Medicaid-eligible youth with autism, serious emotional disturbance, or those eligible for the agency’s developmental disabilities program now have access to Applied Behavioral Analysis services—a type of therapy that can improve social, communication, and learning skills through positive reinforcement.
  • Nebraska – The Nebraska Department of Health and Human Services announced two incentive programs providing up to $200,000 in student loan repayment for qualified medical care providers who agree to work in rural and under-resourced communities in state or federally designated shortage areas.
  • Oregon – The Oregon Health Authority released a report on increasing healthcare costs, which grew 49% per person across insurance markets between 2013 and  2019 in Oregon, outpacing national healthcare cost growth during the same time period. By market, Medicare costs per person grew 58%, commercial market costs per person grew 45%, and Medicaid costs per person grew the slowest at 32%.
  • Tennessee – TennCare announced that it will submit another amendment to its TennCare III Medicaid waiver, addressing changes requested by CMS. CMS asked TennCare to submit a new budget based on a traditional per member per month cap, remove the waiver’s closed formulary for pharmaceuticals, and modify its Medicaid terms and conditions to ensure benefits and coverage will not be cut. Tennessee is accepting public comments on the amendment through August 19, 2022. 
  • Washington – The Washington Health Care Authority and Department of Social and Health Services submitted a waiver renewal application for the Medicaid Transformation Project (MTP), the state’s Section 1115 Medicaid demonstration waiver. The waiver seeks to continue the current MTP programs and implement additional program expansions in long-term services and supports; foundational community supports; substance use disorder institution for mental diseases (IMD); and mental health IMD. The waiver also seeks approval for several new programs, including continuous Apple Health (Medicaid) enrollment for children through their sixth birthday and Apple Health postpartum coverage extension to 12 months.