July 3 Update

In This Week’s Update:

  • Best Practices: Reporting Unwinding Data
  • Social Insurance during the Pandemic: Successes, Shortcomings, and Policy Options for the Future
  • Celebrating Black Women Leaders in Medicaid
  • State Employee Health Plan Cost Growth
  • State updates: AZ, CT, DC, IL, MA, MD, MN, NJ, NV, NY, PA, VA, WA & WI


Best Practices: Reporting Unwinding Data

Last week, State Health and Value Strategies (SHVS) published a new expert perspective, Best Practices for Publicly Reporting State Unwinding Data. As unwinding data is becoming public, it can be difficult to compare across states as they are staging redeterminations in different months and states are using different terminology, definitions, and population denominators in their reporting. This expert perspective highlights recommended best practices for states to follow such as the timely release of data, prioritizing key measures, publishing disaggregated data, and providing context and transparency. SHVS continues to monitor the states that are publicly reporting their unwinding data either in the form of data dashboards or static pdfs and the states posting copies of their required CMS Monthly Unwinding Data reports. 


Social Insurance during the Pandemic: Successes, Shortcomings, and Policy Options for the Future

A new report by the COVID-19 Task Force Policy Translation Working Group describes and evaluates the performance of the nation’s social insurance system during the pandemic and highlights its successes as well as its shortcomings. As is well known, the U.S. social insurance system helps protect individuals and families from risks to their economic wellbeing. In times of crisis like the pandemic, the U.S. social insurance system becomes even more important. The report assesses the performance of pre-existing social insurance and related programs, temporary changes in those programs made in response to the pandemic, and some new federal and state policies. Without the major legislative and administrative changes implemented by Congress during the pandemic—including changes to Medicaid and the Affordable Care Act—households would have experienced much greater financial distress and worse health outcomes. However, the pandemic also highlighted that the social insurance system provides different levels of protection depending on the state in which individuals and families happen to live.


Celebrating Black Women Leaders in Medicaid

A new blog post by the Center for Health Care Strategies (CHCS) highlights key themes from a roundtable with three Black women leaders in Medicaid, who share how state agencies can better support women like themselves pursuing leadership roles. Adrienne Fegans, deputy director of programs and operations at the Virginia Department of Medical Assistance Services; Nicole Harris, executive director, Children’s Health Insurance Program, for the Commonwealth of Pennsylvania; and Shanique McGowan, behavioral health program manager at the New Jersey Division of Medical Assistance and Health Services participated in the roundtable. These leaders discuss the importance of mentoring, engaging, empowering, and celebrating Black women in Medicaid to support their career development. The women were participants in the Medicaid Pathways Program, a national initiative led by CHCS with support from the Robert Wood Johnson Foundation.


State Employee Health Plan Cost Growth

Healthcare costs are on the rise in the U.S., especially as increasing consolidation among hospitals and health systems allows providers to seek higher reimbursement from commercial payers—including state employee health plans (SEHPs). SEHPs provide health insurance for state and local government employees, which are often the largest commercial healthcare purchaser within a state and can be uniquely positioned to tackle high healthcare costs. Researchers at the Georgetown University Center on Health Insurance Reforms conducted the first nationwide survey of SEHP administrators regarding their plan offerings and cost containment strategies. The report assesses the current status of SEHPs’ cost containment efforts, as well as the impact of federal policy changes, to identify successes, challenges, and lessons learned over the past two years.

State updates: AZ, CT, DC, IL, MA, MD, MN, NJ, NV, NY, PA, VA, WA & WI

  • Arizona
    • Governor Katie Hobbs signed two executive orders to ensure the state employee healthcare plan covers medically-necessary gender-affirming surgery and bars state agencies from funding, promoting, or supporting conversion therapy treatment for minors.
    • The Arizona Health Care Cost Containment System (AHCCCS) has opened a public comment period through August 21, 2023 to solicit input on the request for federal approval to extend Medicaid reimbursement to parents who provide caregiver services to their minor children. AHCCCS received temporary federal approval to allow for parents to be reimbursed for providing the “extraordinary care” required of them throughout the course of the pandemic.
  • Connecticut – Governor Ned Lamont signed legislation that enacts a series of initiatives focused on reducing healthcare costs and improving the delivery of care for Connecticut residents. Some of the major provisions include a drug discount card program which will allow Connecticut residents to receive savings up to 80% on generics and 20% on brand name drugs; increased transparency for high cost drug increases; expanded prohibitions on facility fees; and the requirement for the Department of Social Services to conduct an assessment to address barriers that impact health outcomes for Medicaid members.
  • District of Columbia – DC Health Link, the district’s official health insurance Marketplace, announced an extended deadline for coverage under the HealthCare4ChildCare program. The program provides employees of licensed childcare centers and homes with free or lower premium health insurance coverage.
  • Illinois
    • Governor JB Pritzker signed legislation authorizing a new State-Based Marketplace for Illinois. The Department of Insurance and the Department of Healthcare and Family Services will work together to implement the new legislation and coordinate with all state medical assistance programs.
    • Illinois submitted an extension application for its Behavioral Health Transformation demonstration which it requests to rename the “Illinois Healthcare Transformation Demonstration.” Illinois proposes the following benefits and pilots under the demonstration extension: 1) substance use disorder (SUD) services in institutions for mental diseases; 2) SUD case management; 3) housing supports; 4) supported employment services pilot; 5) medical respite; 6) food and nutrition services; 7) violence prevention and intervention pilot; 8) non-medical transportation to needed, non-medically related services, supports, or locations; 9) justice-involved community reintegration; and 10) community reintegration.
  • Massachusetts – The Massachusetts Health Connector, the state’s official health insurance Marketplace, shared an update on Medicaid redeterminations and transitions to the Heath Connector during a June 8 board of directors meeting. As of June 5, a total of 34,645 individuals were found eligible for Marketplace coverage and 7,997 individuals, or 23%, enrolled in a plan.
  • Maryland
    • The Maryland Department of Health announced non-citizen pregnant Marylanders with income up to 250% of the federal poverty level will have access to Medicaid coverage, effective July 1. The Department estimates approximately 6,000 non-citizen pregnant Marylanders will be eligible in the first year. The benefit will provide coverage during the pregnancy and four months of comprehensive coverage during the postpartum period.
    • The Maryland Department of Health announced Caring Out Loud, a year-long partnership with the Trevor Project to bring trainings, resources and support to LGBTQ+ Marylanders. The Caring Out Loud campaign will include LGBTQ+ focused training for the department’s Behavioral Health Administration staff, members of the Governor’s Commission for Suicide Prevention, and healthcare professionals across the state.
  • Minnesota – The Minnesota Department of Human Services announced it will extend the deadline to renew Medicaid for 35,500 people whose renewal paperwork is overdue for July 1 coverage. The state is working with the federal government to avoid ending coverage for people who may still qualify, but face barriers such as not receiving the form in the mail. As we featured in our June 23 States of Unwinding post, Michigan has also taken up this new flexibility announced by CMS.
  • Nevada – Nevada Health Link, the state’s official health insurance Marketplace, Nevada Medicaid and the Division of Welfare and Supportive Services issued a press release about how the state agencies are working together to keep Nevadans insured during the unwinding. During the months of April and May, 94% of those who applied for health coverage after being transferred to the Marketplace from Medicaid were found eligible to enroll, and 74% of those who applied were additionally found eligible for financial assistance.
  • New Jersey – The New Jersey Department of Health released its annual Hospital Maternity Care Report Card which shows cesarean delivery rates have continued to drop for all delivery hospitalizations. These delivery rates have steadily improved since the release of the first report card. Disparities continue to persist among Black and Latina/o parents in New Jersey.
  • New York – New York State of Health, the state’s official health insurance Marketplace, created a webpage with information for employers on the unwinding. The webpage includes information for employers that offer insurance coverage to their employees and where to direct employees if employer-sponsored coverage is not offered. Resources include a fact sheet for employees, frequently asked questions for employers and a letter to employers on redeterminations and coverage.
  • Pennsylvania – The Pennsylvania senate unanimously confirmed Michael Humphreys to serve as Insurance Commissioner of the Pennsylvania Insurance Department. Governor Josh Shapiro nominated Humphreys, who previously served as Acting Insurance Commissioner under Governor Tom Wolf. Congratulations Mike!
  • Virginia – The Virginia Department of Medical Assistance Services published a list of frequently asked questions for providers about the state’s 12-months Medicaid postpartum continuous coverage, which became a permanent policy on July 1.
  • Washington – The Washington State Health Care Authority announced that the current Washington Family Planning Only (FPO) 1115 demonstration waiver has been extended one year, pending CMS review of the state’s application for a five-year renewal. FPO covers preventive family planning visits, cervical cancer screenings, and other reproductive health services. Income eligibility is 260% of the federal poverty level.
  • Wisconsin – The Wisconsin Department of Health Services is seeking input to inform proposed changes to the Family Care and Family Care Partnership waivers. Family Care and Family Care Partnership are Medicaid long-term care programs for older adults and adults with disabilities. Together, the programs serve about 57,000 people across Wisconsin.