June 12 Update

In This Week’s Update:

  • SHVS Updated Expert Perspective
  • Marketplace Network Adequacy and Usability
  • Enhancing Access to Medicaid Family Planning Program Services
  • Adults Who Did Not Take Medication as Prescribed to Reduce Costs
  • State updates: CA, CO, CT, ID, IL, MA, MD, ME, ND, NJ, NY, SC, SD, TX & UT


SHVS Updated Expert Perspective

Last week, State Health and Value Strategies (SHVS) updated their expert perspective State Reporting to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement. To date, 23 states and the District of Columbia have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. The expert perspective includes an interactive map with links to state dashboards and reports to CMS. SHVS will continue to update this EP as more states publish their unwinding data.


Also last week, SHVS added a new product to their one-stop unwinding communications resource page that states can customize to outreach to children and families with mixed eligibility. A Spanish translation of the template language is forthcoming. SHVS has also created social graphics that states can post along with the messaging to social channels. Other recent additions to their communications resources for states include social graphics in English and Spanish to alert enrollees about potential scams as well as sample messages


Marketplace Network Adequacy and Usability

Over the past decade, the number of Americans who purchase their health insurance through the ACA Marketplace has risen to an all-time high. But how easy is it for people to actually use their Marketplace plans? Join the Robert Wood Johnson Foundation and a panel of experts to learn about their latest research into the adequacy and usability of Marketplace plans, and discuss how we can best advocate for improvements so that all consumers have access to affordable and adequate healthcare. Registration for the webinar on Wednesday, June 21, 2023 at 10:30 a.m. ET can be found here.


Enhancing Access to Medicaid Family Planning Program Services

State Medicaid programs have an extraordinary opportunity to expand access to family planning services through Medicaid family planning programs. Medicaid family planning programs cover a suite of family planning services for individuals not otherwise eligible for full-scope Medicaid; to date, 30 states across the country have established Medicaid family planning programs. A new issue brief from Manatt Health, in partnership with Arnold Ventures, provides state-level best-practice strategies that serve as an actionable roadmap for states seeking to adopt family planning programs, as well as for states with existing programs looking to bolster participation and utilization rates. Informed by a state-by-state analysis of Medicaid family planning program enrollment and utilization rates, the strategies described in the executive summary and issue brief can help state Medicaid programs and stakeholders identify gaps in current practices, develop effective action plans, and create sustainable systems for improving access to critical family planning program services. Manatt Health is also hosting a webinar to review these best practice strategies on June 22, 2023.  


Adults Who Did Not Take Medication as Prescribed to Reduce Costs

According to data from the Centers for Disease Control and Prevention’s National Center for Health Statistics, about nine million U.S. adults in 2021 reported not taking medications as prescribed because of costs. Americans cut corners on their medication intake by skipping doses of prescribed drugs, taking less than the prescribed dose or delaying filling a prescription. The data also showed that the percentage of adults aged 18 to 64 not taking medication as prescribed varied across determinants like insurance status, income and disability status. The percentage of adults not taking medication as prescribed decreased as family income increased. And the most likely demographics to not take their medication as prescribed were those who lacked health coverage, those in fair or poor health and those with disabilities.


State updates: CA, CO, CT, ID, IL, MA, MD, ME, ND, NJ, NY, SC, SD, TX & UT

  • California – The California Department of Aging announced the launch of the CalGrows workforce training and development program. The program allows caregivers for older adults and adults with disabilities the chance to receive free job training and earn up to $6,000 in incentives.
  • Colorado – Governor Polis signed legislation in support of the health of youth and older adults in the state. HB23-1003 improves behavioral health screenings for students in middle and high school to ensure they can get connected to mental health resources as soon as possible and HB23-1269 ensures young Coloradans have the support and resources they need to thrive. SB23-031 improves healthcare access for older Coloradans.
  • Connecticut – Governor Lamont and the Connecticut Hospital Association announced an agreement on health-related legislative policies that will reduce healthcare costs for Connecticut families and improve the delivery of care in the state. Provisions of the agreement include enhancing competition; improving transparency in insurer contracting practices; committing to develop a strategy to improve healthcare outcomes and health equity to support Medicaid members; publishing a list of large drug price increases every year; and requiring transparency from drug marketers.
  • Idaho – The Idaho Department of Health and Welfare announced that the state has processed 91,350 Medicaid renewals, of which 25,070 individuals were determined eligible and 66,280 were found ineligible or did not respond to their renewal.
  • Illinois – Governor JB Pritzker signed the fiscal year 2024 budget into law which includes investments in health and human services by providing funding for: the Department of Children and Family Services to hire and train new staff; to begin implementation of the Children’s Behavioral Health Transformation Initiative; reproductive health initiatives; a state-based Marketplace; and to overhaul the state’s disease monitoring IT systems and prepare for future public health emergencies.
  • Maine – The Maine Department of Health and Human Services released a progress update on efforts to advance health equity in communities at higher risk of COVID-19 and address systemic health inequities revealed during the pandemic. Efforts, which were funded by a COVID-19 Health Disparities grant of over $32 million from the U.S. Centers for Disease Control and Prevention, included: investment in tribal communities and community-based organizations; addressing the end of the Medicaid continuous coverage requirement; and expanding COVID testing.
  • Maryland – Governor Wes Moore signed an executive order to protect gender affirming healthcare In Maryland. The order will protect those seeking, receiving, or providing gender affirming care in Maryland from attempts at legal punishment by other states.
  • Massachusetts – To ensure Massachusetts residents retain their health coverage during the unwinding, the state has created the “MassHealth Redetermination Campaign,” a collaboration between MassHealth, the Massachusetts Health Connector (the state’s official health insurance Marketplace), Health Care for All, community-based groups and health providers. The state is promoting a webpage with campaign information and a marketing toolkit.
  • New Jersey – The Department of Children and Families released a request for proposals from partner-agencies for universal newborn home visiting which will provide the option for a family to request a nurse visit in the home to ensure mother and baby have received appropriate health check-ups and screenings and referrals to additional services as necessary. This model of family support is demonstrated to improve maternal and infant health outcomes and the family’s overall sense of wellness and wellbeing.
  • New York
    • CMS announced that New York’s Section 1332 waiver has been deemed complete. A federal comment period on the waiver closes on July 5, 2023.
    • The New York Department of Financial Services released a report analyzing the long-term care (LTC) insurance market. Approximately 394,000 New Yorkers have policies as of 2020, compared to 754,000 in 2002 and only a fraction of the insurers that sold LTC policies in New York still do so today.
  • North Dakota – North Dakota Health and Human Services announced that about 13,100 North Dakota Medicaid members were due for a renewal on May 31, and only about one in three members who were sent a renewal form returned it. As a result, 4,421 people were disenrolled.
  • South Carolina – Director Robby Kerr of the South Carolina Department of Health and Human Services (SCDHHS) documented in a letter to Governor McMaster the progress in the SCDHHS-led initiative to improve access to mental health counselors in South Carolina’s schools. Data from a statewide January 2023 survey of mental health services available in schools conducted in partnership with the Department of Education show the ratio of counselors-to-students has improved, the number of counselors has increased by 65.8% since 2022, and 118 schools gained access to mental health counselors.
  • South Dakota – South Dakota received CMS approval to expand Medicaid coverage to adults with incomes up to 133% of the federal poverty level beginning July 1, 2023. With the addition of South Dakota, 39 states plus the District of Columbia have expanded Medicaid under the Affordable Care Act. As a reminder, SHVS published an issue brief on the provision in the American Rescue Plan Act of 2021 that provides states that implement expansion after enactment with a significant increase in Medicaid funding.
  • Texas – Texas Health and Human Services announced Emily Zalkovsky as the state’s Medicaid Director, effective July 1. Zalkovsky, who has 18 years of experience in health and human services policy and operations, currently serves as the deputy state Medicaid director. Congratulations Emily!
  • Utah – The Utah Department of Health & Human Services submitted a request to amend their section 1115 demonstration to extend postpartum coverage from 60 days to 12 months for certain postpartum women. As a reminder, SHVS published an issue brief on the ARP option to extend postpartum coverage.