June 21 Update

In This Week’s Update:

  • New SHVS Unwinding Resources
  • Budget Neutrality Requirements
  • Healthcare Debt in America
  • Help Improve Medicaid and SNAP Data Coordination
  • Reducing Health Disparities Among the Medicaid Population
  • State Updates: DC, LA, ME, MI, MN, NE, NJ, NM, NC, OR, VA & WA

New SHVS Unwinding Resources

Last week, State Health and Value Strategies published two new resources for states to support the unwinding of the Medicaid continuous coverage requirement. Leveraging Section 1902(e)(14) Waiver Authority Amid Unwinding outlines the time-limited targeted enrollment flexibilities that CMS has made avaliable to states. These flexibilites can provide significant relief to states as they resume normal operations at the end of the PHE given. Using Marketplace Retroactive Coverage to Facilitate Continuous Enrollment in the Public Health Emergency Unwinding describes the retroactive coverage policy innovation and its benefits, and offers strategies for states to consider in their implementation that will maximize coverage continuity, minimize adverse selection, and address potential operational challenges.

Also, Health Affairs Forefront published an article on budget neutrality requirements for 1115 demonstration waivers. The article highlights how current section 1115 budget-neutrality policy is a major barrier to state investments in their Medicaid programs to address health disparities and advance equity. For an overview of the main takeaways from the article, check out this twitter thread.

Share Your Perspectives to Help Improve Medicaid and SNAP Data Coordination

What are opportunities to improve data sharing between Medicaid and SNAP? Benefits Data Trust and the Center for Health Care Strategies invite those who oversee Medicaid and/or SNAP eligibility and enrollment data processes to complete a survey to share their perspectives. Survey findings will inform actionable policy and practice recommendations as well as practical case studies and technical assistance opportunities. Click here to complete the survey. 

Healthcare Debt in America

Kaiser Health News launched a new project, Diagnosis: Debt, which examines America’s medical debt crisis. The first installment in the series, which draws on a new KFF poll conducted for the project and new Urban Institute research, reveals that more than 100 million people in the U.S.—including 41 percent of adults—are now beset by healthcare debt. The first installment profiles a group of Americans burdened by medical debt, including a mother of twins in Chicago forced to work double shifts and borrow from family, a retired Virginia couple driven into bankruptcy and a medical student in Texas harassed for years by debt collectors for a $131 exam she was given after being sexually assaulted. Future stories in the series will explore the burden of medical debt on people with cancer, how this debt is deepening racial disparities and how a burgeoning credit industry is feeding off patients’ inability to pay their bills.

How States Can Engage with Health Plan Foundations to Address Health Disparities

States are increasingly looking to identify promising practices and innovative approaches to close the gap in health outcomes, experiences of care, and address social determinants of health to reduce health disparities among the Medicaid population. The National Opinion Research Center at the University of Chicago will host a webinar on July 18, from 3:00 to 4:00 p.m. ET, discussing how state Medicaid agencies can engage with health plan foundations to address health disparities. Three examples of such innovative programs of varying size and scope, to support the diverse needs of Medicaid enrollees, include: 1) UCLA Health Equity Challenge: A local-level innovation to foster fresh ideas and address the needs of low-income and vulnerable populations by inviting UCLA graduate students to propose solutions that community-based organizations can implement to improve health equity in California; 2) Michigan Early Childhood Investment Corporation – Think Babies Movement: A mini grant model to pilot and test outreach and navigation efforts to increase access and enrollment in critical prenatal-to-three services; and 3) Medicaid Innovation Collaborative: A model helping states leverage their managed care organizations to connect their Medicaid agency goals with private-sector, tech-enabled solutions.

  • Lousiana
    • The Lousiana Department of Health (LDH) is hosting a virtual session that will bring together Louisianans who have engaged in COVID-19 outreach, education, and vaccination efforts to share what has worked and not worked, discuss best practices, and ideas for the future. The Action Lab will provide information about successful equity-centered COVID-19 vaccination efforts, common challenges and strategies, and new grants available for COVID-19 vaccine equity initiatives.
    • LDH announced its intent to award a Medicaid managed care organization contract to incumbent UnitedHealthcare in addition to the five other health plans named in February 2022. LDH expects new MCO contracts to go live in January 2023.
  • Michigan – The Michigan Department of Health and Human Services announced they will host three virtual baby fairs for new or expecting parents this month. At the virtual events, families will have an opportunity to learn about available resources, important health and safety information and ask questions directly to program experts.
  • Nebraska – The Nebraska Department of Health and Human Services has updated the Nebraska Behavioral Risk Factor Surveillance System Dashboard with the latest data through 2020. The dashboard allows health professionals and the public to explore data on a variety of health topics and is also used to identify new and emerging health issues, establish and track health objectives, and evaluate disease prevention measures. Starting this year, the dashboard is hosted on a new platform called the Nebraska Public Health Atlas, which provides greater access to public health data and improved visualizations of the data.
  • New Jersey – The Murphy administration announced the launch of a new pilot program to train law enforcement officers and community stakeholders on how to recognize and interact with children and families affected by substance use disorder and connect them with systems of care. The program, known as the Child Trauma Response Initiative, will launch in three pilot municipalities across the state, which were identified based on an assessment of their need and existing resources.
  • New Mexico – BeWellnm, the New Mexico health insurance exchange, announced that as it begins its search for a permanent CEO, it has contracted with GetInsured to provide consultative and operational support during the period of transition. GetInsured will provide temporary, interim operational leadership for a 10-month period and offer strategic oversight and direction to beWellnm, along with long-term recommendations for maintenance and operations. Heather Korbulic, senior policy and strategy lead at GetInsured and former executive director of the Silver State Health Insurance Exchange in Nevada for six years, will provide temporary executive leadership for beWellnm.
  • North Carolina – The North Carolina Department of Health and Human Services announced the award of nearly 16 million dollars across 20 healthcare centers, treatment clinics and community-based providers to expand evidence-based treatment, housing, employment and transportation services for Opioid Use Disorder.
  • Oregon
    • The Oregon Health Authority (OHA) announced new rules that go into effect July 1 and will require healthcare providers reimbursed with public funds to work with credentialed healthcare interpreters qualified or certified by OHA. The rules drafted by OHA reflect changes in the requirement for healthcare interpreting services that were made by the state Legislature’s passage of House Bill 2359 during the 2021 session. These new rules will ensure that people for whom English is a second language (those with limited English proficiency) or who use sign language can access high-quality interpreting services.
    • OHA published a new report, Climate Change and Youth Mental Health in Oregon, which shows climate change disasters are affecting youth mental health and leading to feelings of hopelessness, despair, anxiety and frustration. OHA’s Environmental Health Assessment Unit prepared the report in response to Governor Kate Brown’s Executive Order 20-04, which directs OHA to study the impacts of climate change on youth mental health and depression as a component of a broader youth mental health crisis.
  • Virginia – In January 2022, Virginia became the latest state to cover doula services through its Medicaid program. The Department of Medical Assistance Services issued an invitation to existing doulas and interested individuals to apply to become a state-certified community doula and join the Virginia Medicaid program as a provider.
  • Washington – The U.S. Department of Health and Human Services and the Department of the Treasury deemed Washington’s application for its Section 1332 waiver complete. The waiver seeks to allow all Washingtonians to purchase qualified health plans through the state exchange, Washington Healthplanfinder, thereby allowing all qualifying low-income residents to benefit from new state-funded affordability programs for plan years 2024 through 2028. Public comments on Washington’s waiver application will be accepted by the Departments from June 15, 2022 through July 14, 2022.
  • Maine, Minnesota, New Mexico and Washington D.C. – CMS approved the extension of Medicaid and CHIP coverage for 12 months after pregnancy in these four states under the new state plan opportunity established by the American Rescue Plan Act. As a result, up to an additional 15,000 people annually in these states—including 2,000 in Maine; 7,000 in Minnesota; 5,000 in New Mexico; and 1,000 in Washington, D.C.—will have access to Medicaid or CHIP coverage for a full year after pregnancy. As a reminder, SHVS published an issue brief that reviews the ARP state option to extend postpartum coverage.