In This Week’s Update:
- HRA Rule
- MACPAC Report to Congress
- State Updates: DC, NJ, NV, NY, OH, SC & WA
- Precarious Work Schedules of Medicaid Beneficiaries
- Supporting Families with Young Children
Last week, the U.S. Departments of Health and Human Services, Labor, and Treasury released final regulations easing the rules governing health reimbursement arrangements (HRA) and other account-based, tax-preferred health care benefits. The rule is effective in 2020, which raises important considerations about marketplace readiness and potential tax consequences for individuals. For further context, read Jason Levitis’s take on the final HRA rule in a write-up for the Brookings Institution.
MACPAC Report to Congress
Also last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2019 Report to Congress on Medicaid and CHIP, which responds to congressional requests for analysis and makes recommendations on Medicaid payment and coverage policies for outpatient prescription drugs, hospital payment, program integrity, and therapeutic foster care.
State Updates: DC, NJ, NV, NY, OH, SC & WA
- District of Columbia – The District submitted an application for a new Section 1115 demonstration that would allow D.C. to receive federal financial participation for inpatient, residential and other services provided to otherwise-eligible Medicaid beneficiaries while residing in institutions for mental diseases (IMD) for diagnoses of substance use disorder and/or serious mental illness/serious emotional disturbance. The federal comment period is open from June 11, 2019 through July 11, 2019.
- Nevada – Governor Steve Sisolak signed Senate Bill 544, which creates the Patient Protection Commission (PPC). The PPC will examine health care costs and review disparities in the provision of health care across communities, including the adequacy of health care providers and availability of health insurance plans. The PPC will have 11 members appointed by the governor with recommendations from legislative leadership and will include representation from across the industry and patient advocates to represent health care consumers.
- New Jersey – Governor Phil Murphy announced free distribution of naloxone, the opioid overdose reversal drug, at participating pharmacies throughout New Jersey on June 18. As part of Governor Murphy’s initiative to combat the opioid crisis, New Jerseyans will be able to visit participating pharmacies and anonymously obtain naloxone at no cost on June 18, without an individual prescription or an appointment.
- New York – The New York Department of Health released a request for applications for the Money Follows the Person Transition Assistance program designed to shift health care priorities away from institutional care and toward long term care provided in the community. New York is seeking an organization to operate a statewide Transition Center infrastructure, which will provide education about community living options, transition assistance, and outreach to nursing homes to support the transition of individuals from institutional to community-based settings.
- Ohio – The state is conducting a competitive managed care procurement to reform its current managed care program to focus on the individual rather than the business of managed care. The Ohio Department of Medicaid is engaging stakeholders early in the process and wants to hear from individuals and providers first and has released a Request for Information (RFI) for stakeholders to share their experience of the current program as well as ideas and solutions for improvement.
- South Carolina – South Carolina submitted an application requesting a new five-year Section 1115 demonstration to implement a community engagement requirement and a targeted substance use disorder program. The Centers for Medicare & Medicaid Services (CMS) is accepting comments on the waiver through July 10, 2019.
- Washington – The state is the fourth to gain federal approval to negotiate with drug manufacturers for deals that link payment for prescription drugs to the value delivered. CMS approved Washington’s proposed Medicaid state plan amendment last week. Washington’s first use of this approval will be for purchasing hepatitis C drugs, under a recently announced agreement with drug manufacturer AbbVie.
The Precarious Work Schedules of Nondisabled Adults
A number of safety net programs, including Medicaid, the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), and rental assistance programs are adding or expanding work requirements as a condition of eligibility. Work requirement policies typically require nondisabled adults who don’t qualify for an exemption to work or participate in work-related activities for a minimum number of hours per week or month to continue receiving benefits. A new study by Urban Institute researchers shows that many program participants have low-wage jobs characterized by precarious work schedules, which could pose challenges to consistently meeting minimum hour requirements and maintaining access to the safety net. The study’s authors note that the lack of predictability or control over one’s work schedule may not only affect the ability of safety net participants to meet work requirements through their main jobs, but also their ability to consistently meet the minimum hour requirement through other jobs or approved work-related activities.
Supporting Families With Young Children to Improve Health Outcomes
Families with young children face a number of challenges that can influence a child’s opportunities for health and success, ranging from financial insecurity to caregiver depression. The support that families receive during early childhood can lay the foundation for a child’s future health outcomes, educational attainment and success in adulthood. A new brief published by PolicyLab at Children’s Hospital of Philadelphia describes three key areas in which PolicyLab researchers are developing and sustaining programs and policies aimed at supporting young children and their families: 1) promoting early childhood language and literacy, 2) supporting social-emotional and healthy development, and 3) supporting caregivers’ health and parenting skills. The brief outlines potential policies for state health officials looking to work across silos in their state and develop cross-agency partnerships to support young children and their families.