June 20 Update

In This Week’s Update:

  • HHS letter to governors on Medicaid redeterminations
  • SHVS’ State Health Equity Measure Set
  • CMS’ National Health Expenditure Projections
  • KFF Report on Consumer Experiences in Health Insurance
  • NAMD’s Perspective on Unwinding
  • State updates: AR, HI, IN, KS, KY, MD, ND, NH, NM, NY, SC & WI


Letter to Governors on Medicaid Redeterminations

Last week, HHS Secretary Becerra issued a letter to governors in response to early state data on Medicaid redetermination outcomes. The letter expresses concern related to high rates of disenrollments for procedural reasons as well as coverage loss among children, and encourages states to redouble their efforts. To support these objectives, CMS released a suite of resources, including Strategies to Prevent Procedural Terminations, detailing new or updated section 1902(e)(14) waiver strategies.

CMS added new or updated resources to their resources page including: an Unwinding Update and Partner Call to Action; an updated list of Section 1902(e)(14) Waiver Approvals; and an updated Communications Toolkit


SHVS’ State Health Equity Measure Set

State Health and Value Strategies published the State Health Equity Measure Set, which provides a standard set of health equity measures states can use to assess their performance against other states, and inform interventions that strive to improve equity in healthcare access and outcomes within their state. A companion issue brief outlines state considerations when adopting the Measure Set and describes key steps for how to operationalize the Measure Set


CMS’ National Health Expenditure Projections

Healthcare spending will make up roughly 20% of the American economy, or $7.2 trillion, by 2031, according to new estimates from CMS’ Office of the Actuary, published in Health Affairs. Though the authors expect Medicaid enrollment to decline as states continue the unwinding of the Medicaid continuous coverage requirement and redetermining their enrollees and the uninsurance rate to increase, they expect the uninsured rate to remain below 10% because of projected increases in enrollment in private health insurance from enhanced Marketplace subsidies.


KFF Report on Consumer Experiences in Health Insurance

A new KFF survey of consumer experiences with health insurance finds that most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year. A report on the survey findings explains that problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and delays and denials of care that involved an insurer’s prior authorization.


NAMD’s Perspective on Unwinding

In response to HHS Secretary Becerra’s letter calling on governors to ensure that Medicaid members who remain eligible for the program don’t lose coverage, Kate McEvoy, Executive Director of the National Association of Medicaid Directors (NAMD), authored a blog post affirming NAMD’s alignment with the goal of retaining people who continue to qualify. The blog post emphasizes that Medicaid is always open for new enrollment or reenrollment, and that data will continue to change as the unwinding process continues and states pivot their approach to address emerging issues of concern. A second blog post from NAMD outlines the factors influencing early data on unwinding, including states’ outreach efforts and how states opted to prioritize renewals. 

State updates: AR, HI, IN, KS, KY, MD, ND, NH, NM, NY, SC & WI

  • Arkansas
    • Arkansas requested to amend their Medicaid section 1115 demonstration entitled “Arkansas Health and Opportunity for Me (ARHOME).” The proposed amendment would provide additional supports to underemployed and unemployed adults in ARHOME. The proposed amendment also seeks to expand Success Life360 HOME eligibility.
    • The Arkansas Department of Human Services released updated figures reflecting the second month of Medicaid redeterminations. The state disenrolled 68,838 Medicaid enrollees in May.
  • Hawaii – Governor Josh Green signed legislation to expand access to healthcare on Maui and to uplift career advancement opportunities for healthcare workers in the state. The legislation also authorizes funds for the completion of a West Maui Hospital and Medical Center to provide greater access to healthcare and generate job opportunities.
  • Indiana – The Indiana Family and Social Services Administration’s Division of Mental Health and Addiction is providing new funding to help build and support projects across Indiana to improve mental health and recovery services. This includes funding from the federal American Rescue Plan Act and the National Opioid Settlement, and totals more than $76 million.
  • Kansas – Governor Laura Kelly announced that the Kansas Department for Aging and Disability Services is receiving more than $3.6 million as part of a five-year federal grant to implement youth suicide prevention and early intervention strategies.
  • Kentucky 
    • Kentucky submitted an amendment to the section 1115 demonstration titled KY HEALTH, requesting authority to: (1) reimburse medically necessary short-term inpatient treatment services within settings that qualify as institutions for mental diseases for Medicaid-eligible adults with serious mental illness; and (2) implement a recuperative care pilot program to adult enrollees who are homeless or at risk of homelessness, and need additional medical support and care coordination.
    • The Kentucky Cabinet for Health and Family Services released a Medicaid renewals snapshot as of June 1. Also, the Kentucky Health Benefit Exchange released its June monthly unwinding data report.
  • Maryland – The Maryland Department of Health announced the initial data from the first round of Medicaid renewals. For the month of May, Maryland Medicaid processed 119,803 renewals. Of these, 76,104 were determined eligible to have their coverage extended; 10,032 were determined to be not eligible based on information provided and were disenrolled; and 24,643 were disenrolled for procedural reasons, such as not updating eligibility information.
  • New Hampshire – The New Hampshire Department of Health and Human Services announced that the state has been named number one for child well-being in the 2023 Annie E. Casey Foundation’s KIDS COUNT Data Book. The Data Book, a 50-state report of recent household data, presents national and state data from 16 indicators in four domains—economic well-being, education, health, and family and community factors.
  • New Mexico – The New Mexico Human Services Department launched a multi-media, bilingual campaign called “Game of Chance,” to raise awareness about the opioid overdose crisis. The campaign provides information on what medication assisted treatment is, safe drug use, ending stigma, where to get and how to use the lifesaving overdose reversal spray, Naloxone, and peer recovery stories.
  • New York 
    • The state received approval from CMS to expand Medicaid and CHIP postpartum coverage to one year through the American Rescue Plan (ARP). With the addition of New York a total of 35 states and the District of Columbia have extended postpartum Medicaid/CHIP coverage to a full year.
    • The New York State Department of Financial Services released the 2024 requested rate changes from carriers in New York’s individual and small group market. The proposed rates are currently under review.
  • North Dakota – North Dakota Health and Human Services announced that Sarah Aker has been selected as Medicaid Director, effective July 24. Aker joins the department after serving as the Medicaid Director for the South Dakota Department of Social Services, where she led the implementation of South Dakota’s Medicaid Expansion program. Congratulations Sarah!
  • South Carolina – The South Carolina Department of Health and Human Services (SCDHHS) issued a bulletin to providers stating that only 30% of Medicaid enrollees returned eligibility review forms that the state sent out as part of the redeterminations process, which began April 1. SCDHHS is seeking providers’ help in encouraging Medicaid-enrolled patients to submit their renewals.
  • Wisconsin 
    • The Wisconsin Department of Health Services (DHS) is encouraging Medicaid members to submit their renewals at the “just right” time to avoid delays or gaps in coverage. DHS announced a new renewal status webpage with instructions for Medicaid enrollees to find their renewal month and allowing them to sign up for renewal reminders.
    • Wisconsin DHS has awarded $5.1 million in grants to 14 nonprofit dental clinics to increase access to dental care. Grant awards range from $59,000 to $150,000 per clinic over three years and will enable the selected clinics to serve more children and families in need, including Medicaid members, people who have low income, people with disabilities, and people who are uninsured.