June 10 Update

In This Week’s Update:

  • Health Insurance Coverage Increases in Minority Communities
  • Changes to the Child and Adult Core Measure Sets
  • States of Innovation: May 2024
  • CMS Final Rules Part 3: Home and Community-Based Services
  • State Timelines for Completing Unwinding-Related Renewals
  • State updates: AR, CA, CO, CT, HI, IA, MD, MI, MN, NC, ND, NM, OR, PA & WA

Health Insurance Coverage Increases in Minority Communities
Last week, the U.S. Department of Health and Human Services (HHS) issued five new reports showing historic gains in healthcare coverage among individuals from minoritized communities. The uninsurance rate for the following populations declined as follows from 2010 to 2022, based on available census data: Black Americans: 20.9% to 10.8%; Latinos: 32.7% to 18%; Asian Americans, Native Hawaiians and Pacific Islanders: 16.6% to 6.2%; and American Indians and Alaska Natives: 32.4% to 19.9%. HHS also announced a $500 million investment in Navigators, who play a key role in helping people across the country sign up for healthcare.

Changes to the Child and Adult Core Measure Sets
Also last week, State Health and Value Strategies published a new expert perspective, Changes to the Child and Adult Core Measure Sets to Advance Equity. Beginning in 2025, states will be required to report a subset of Child and Adult Core Set measures by race and ethnicity, sex, and geography. The expert perspective highlights the Core Set measures subject to stratification and describes how the Core Sets serve as a critical tool to monitor health inequities. Updates follow.

States of Innovation: May 2024
SHVS’ States of Innovation series profiles the latest health news at the state level, highlighting what states are working on to achieve better, more affordable, and more equitable health for all. The latest States of Innovation post highlights state activity in May 2024 which includes state efforts to address affordability, increase access to children’s coverage and care, engage community and advance health equity. States also took action on maternal and reproductive health, access to mental and behavioral health, and coverage for justice-involved populations. States of Innovation: May 2024 features updates from Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Georgia, Hawaii, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, Nevada, North Carolina, Oregon, Pennsylvania, Rhode Island, and Tennessee.

CMS Final Rules Part 3: Home and Community-Based Services
Last week, SHVS hosted the final webinar in a three-part series on CMS’ recent Access and Managed Care final rules. Part 3 provided a detailed overview of provisions to enhance access to home and community-based services, standardize quality measures and reporting requirements, and help address long-standing shortages in the direct care workforce. The webinar slides are available.

State Timelines for Completing Unwinding-Related Renewals
CMS recently released an interim, preliminary overview of states’ scheduled timelines for completion of unwinding-related renewals as an update to prior estimates (CMS last provided an update on state unwinding timelines in June 2023). The document reflects preliminary estimates of states’ scheduled timelines to complete a first renewal for individuals who were enrolled in Medicaid or CHIP as of the beginning of the state’s unwinding period. The document also states that additional guidance related to renewal processing and an updated table with state timelines for completion of all unwinding-related renewals is forthcoming.

 

State updates: AR, CA, CO, CT, HI, IA, MD, MI, MN, NC, ND, NM, OR, PA & WA

  • Arkansas – The Arkansas Department of Human Services announced that it will end its Medicaid managed care dental program and return enrollees who qualify for dental coverage to the Medicaid fee-for-service program beginning later this year.
  • California
    • Covered California, the state’s official health insurance Marketplace, announced that more than 158,000 Californians remained covered through the Medi-Cal to Covered California enrollment program over the past year during unwinding of the Medicaid continuous coverage requirement. Under the program, Covered California automatically enrolls individuals in one of its low-cost health plans when they lose Medi-Cal coverage and gain eligibility for financial help through Covered California.
    • On June 27, the Department of Health Care Services will host a webinar, Tools to Better Engage Eligible Members in CalAIM. The webinar is part of a biannual series of webinars designed to highlight best practices for implementing Enhanced Care Management and Community Supports, increase providers’ successful participation in CalAIM, and improve collaboration with Medi-Cal managed care plans, state and local government agencies, and others.
  • Colorado – Governor Jared Polis signed several healthcare related bills into law, including HB24-1164 to expand free menstrual products to students in schools;  SB24-175 requiring health benefit plans to provide coverage for doula services; HB24-121 creating a separate health facility license for critical access hospitals to support rural hospitals; HB24-1045 which includes requirements for insurers related to treating substance-use disorders (SUDs); and SB24-055 creating the agricultural and rural community behavioral health program.
  • Connecticut – Governor Ned Lamont signed legislation strengthening the state’s laws governing paid sick days. Connecticut’s existing laws require employers with more than 50 employees, mostly in specific retail and service occupations, to provide their employees with up to 40 hours of paid sick leave annually. Beginning January 1, 2025, these laws will apply to workers of nearly every occupation and the threshold for coverage will be lowered in three phases, beginning with employers that have at least 25 employees in 2025, those with at least 11 employees in 2026, and those with at least one employee beginning in 2027.
  • Hawaii – Governor Josh Green and the Department of Human Services Med-QUEST Division announced that CMS approved a new state plan amendment to cover community palliative care services through Medicaid, making Hawaii the first state in the nation to do so. Palliative care is specialized medical care for people living with a serious illness.
  • Iowa – The Iowa Department of Health and Human Services is hosting virtual public comment sessions as they establish new Behavioral Health districts that will enhance access to behavioral health services.
  • Maryland – Governor Wes Moore announced the launch of a pilot program in partnership with the Maryland Department of Health and The Trevor Project to reduce deaths from suicide among LGBTQIA+ youth.
  • Michigan – The Michigan Department of Health and Human Services (MDHHS) approved eight pre-paid inpatient health plans (PIHPs) to participate in the Recovery Incentives Pilot, which will expand access to evidence-based treatment for Medicaid enrollees who are living with certain substance-use disorders (SUDs). MDHHS, participating PIHPs and providers will collaborate to deliver motivational incentives, such as gift cards, to people living with an SUD who achieve their treatment goals.
  • Minnesota – The Department of Human Services announced that Minnesotans covered by MinnesotaCare, the state’s Basic Health Program (BHP), will start paying monthly premiums again this summer to maintain their insurance coverage. Monthly premiums were paused during the public health emergency.
  • New Mexico
    • The New Mexico Human Services Department announced Medicaid reimbursement of community health workers (CHWs) and community health representatives (CHRs). CHWs and CHRs are trained, frontline public health workers who serve as a bridge between communities, healthcare systems, and state health departments. New Mexico will be the first state to eliminate the need for CHWs and CHRs to obtain an order from a physician or clinician before they see a new Medicaid member.
    • The New Mexico Office of Superintendent of Insurance (OSI) announced it will hold a kickoff meeting for public and stakeholder engagement related to oversight of healthcare consolidation. Earlier this year, the state passed legislation which gives OSI tools to provide oversight of certain hospital transactions to ensure that such transactions will not drive up healthcare costs, reduce access to services, or diminish the quality of care. OSI invites all interested parties to take part and provide feedback.
  • North Carolina – The North Carolina Department of Health and Human Services (NCDHHS) hosted a Spanish-language webinar on June 6 to discuss the new NCDHHS Community and Partner Engagement Initiative with North Carolina community advocates, partners, leaders, and other members of the Hispanic and Latinx community. NCDHHS launched the initiative earlier this year to address ongoing health disparities.
  • North Dakota – North Dakota Health and Human Services (HHS) has completed all redeterminations related to unwinding. Since April 2023, HHS has reviewed eligibility for over 134,000 Medicaid members.
  • Oregon – CMS approved Oregon’s BHP  blueprint. Through the BHP, Oregon will be able to provide healthcare coverage to individuals with incomes between 138% to 200% of the federal poverty level. Individuals enrolled in the BHP will receive a comprehensive benefit package, including all essential health benefits, and will not be charged premiums or other cost-sharing.
  • Pennsylvania – Governor Josh Shapiro and Pennsylvania Department of Aging Secretary Jason Kavulich announced the publication of Aging Our Way, PA, a 10-year strategic plan that serves as a roadmap for services for older adults, and addresses healthcare, transportation, housing, long-term care, and social connections.
  • Washington – The Washington State Health Care Authority launched a program that expands access to medications for opioid-use disorder (OUD). The program, ScalaNW, equips emergency room clinicians with tools to treat patients for OUD and connect them to community-based care.