June 24 Update

In This Week’s Update

  • State Spotlight: New York’s 1332 Waiver
  • New Funding Opportunity for CMS’ IBH Model
  • Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During Unwinding and Beyond
  • Initiatives to Support Coverage Retention
  • Leveraging Medicaid to Address the Maternal and Infant Crisis
  • State updates: ME, MI, MN, NC, NE, NJ, NY, RI & VA


State Spotlight: New York’s 1332 Waiver 
Last week, State Health and Value Strategies published a new issue brief in its State Spotlight series, New York’s Essential Plan Expansion: A Novel Use of Section 1332 Waiver AuthorityThe brief highlights New York’s new affordable coverage program, made possible with a first-of-its-kind section 1332 waiver. Over 130,000 New Yorkers enrolled in the Essential Plan Expansion with no premiums and minimal cost-sharing requirements in the program’s first month. Other spotlight briefs in the series can be found on this webpage, which features an interactive map. If you have an innovative effort underway in your state that SHVS might highlight through a State Spotlight, please be in touch.

New Funding Opportunity for CMS’ IBH Model
Also last week, CMS announced the release of the Notice of Funding Opportunity application for the Innovation in Behavioral Health (IBH) Model. Up to eight state Medicaid agencies will receive funding to develop the necessary infrastructure and capacity to implement the model, which seeks to improve behavioral and physical health outcomes and quality of care for those enrolled in Medicaid and Medicare with moderate to severe behavioral health conditions. State Medicaid agencies selected to participate will be eligible for up to $7.5 million in funding over the course of the eight-year model, which is set to begin in January 2025 and conclude in December 2032. Applications to participate in the model are due September 9, and CMS will issue awards in mid-December. CMS will hold a webinar on the funding opportunity on July 11. Updates follow.


Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During Unwinding and Beyond
new KFF report highlights findings from the 22nd annual survey of state Medicaid and CHIP programs officials conducted by KFF and the Georgetown University Center for Children and Families in March 2024. The report presents a snapshot of actions states have taken to improve systems, processes, and communications during the unwinding, as well as key state Medicaid eligibility, enrollment, and renewal policies and procedures in place as of May 2024. For example, nearly all state respondents are interested in maintaining 1902(e)(14) waiver flexibilities that have been most useful to streamlining renewal processes. States reported their top three successes during the unwinding including improved outreach and enrollee communication, enhanced stakeholder engagement, and increased ex parte rates.

Initiatives to Support Coverage Retention
On June 18, the Congressional Budget Office (CBO) released a report describing its predicted trends in health insurance coverage for the next decade. The CBO projects that the all-time-high rate of insurance coverage in 2023 represents a peak, and significant numbers of people will become uninsured between 2024 and 2034. However, a new article for Health Affairs Forefront by Sabrina Corlette at Georgetown’s Center on Health Insurance Reforms, explains that these projections are not destiny; several policy actions and investments in the Affordable Care Act (ACA) can help sustain 2023’s low uninsurance rate, and even bring it lower.

Leveraging Medicaid to Address the Maternal and Infant Crisis
In an effort to better address the maternal and infant health crisis, states are increasingly seeking to use Medicaid to cover health-related social needs (HRSN) services and supports for pregnant and postpartum individuals and their children, particularly through Medicaid section 1115 demonstrations. Addressing unmet HRSN among these populations can help stabilize coverage, improve their access to care, and complement traditional medical care to promote maternal and child health more broadly. A report from the Georgetown University Center for Children and Families examines states’ use of Medicaid section 1115 demonstrations to cover housing, nutrition, and other HRSN services and supports for pregnant and postpartum individuals and young children who are experiencing or at risk of unmet HRSN.


State updates: ME, MI, MN, NC, NE, NJ, NY, RI & VA

  • Maine – The Maine Bureau of Insurance published summary tables for the 2025 average rate increases in the individual and small group insurance market. The weighted average increases in rate filings are 14.2% for individual health insurance and 14.5% for small group health insurance.
  • Michigan – Governor Gretchen Whitmer signed Executive Order 2024-4 establishing the Michigan Gun Violence Prevention Task Force. The task force, housed within the Michigan Department of Health and Human Services, will identify root causes of gun violence, compile and report relevant data, maximize existing resources, solicit perspectives from diverse stakeholders, and provide policy recommendations.
  • Minnesota – Governor Tim Walz signed legislation to help ease the burden of medical debt on Minnesotans. The legislation bans medical providers from withholding medically necessary care due to unpaid debt; prevents medical debt from impacting credit scores; establishes new protections from unethical medical debt collections practices; and creates a new process to help people dispute medical coding and billing errors. SHVS has updated its expert perspective mapping state efforts to address medical debt to include Minnesota. As a reminder, SHVS authored an article for Health Affairs Forefront examining state efforts to cancel medical debt.
  • Nebraska – The Nebraska Department of Health and Human Services announced it has successfully implemented Avel eCare’s EMS telemedicine services. Ambulances in more than two dozen rural communities across the state are now equipped with Avel eCare’s telemedicine technology, virtually connecting EMTs and paramedics with Avel eCare’s emergency physicians, paramedics, and nurses for support during transports.
  • New Jersey
    • Gregory Woods has been named as the Assistant Commissioner of the Division of Medical Assistance and Health Services, which administers NJ FamilyCare, the state Medicaid program. Congratulations Greg!
    • The Department of Human Services, Department of Children and Families, and the Higher Education Student Assistance Authority announced a new student loan redemption program to support home and community-based care workers. Eligible workers can receive up to $50,000 in loan relief in exchange for one year of service at an approved home and community-based services provider agency or as a self-directed employee.
  • New York – Governor Kathy Hochul announced that a new law requiring employers to provide 30 minutes of paid break time for breast milk expression went into effect June 19. This mandate applies whenever employees have a reasonable need to express breast milk and extends up to three years following childbirth.
  • North Carolina – The North Carolina Department of Health and Human Services launched a new, multilingual Disaster and Behavioral Health Resources Communications Toolkit to provide communities with guidance and resources to support mental and emotional health before, during, and after a disaster.
  • Rhode Island – The Office of the Health Insurance Commissioner (OHIC) released the individual, small group, and large group market premium rates requested by Rhode Island’s insurers. Requested average rate increases range from 5.6% to 14.3% in the individual market, from 8.8% to 22.7% in the small group market, and from 2.5% to 14.9% in the large group market. OHIC’s final decision to approve, modify, or reject the proposed rates is expected in August.
  • Virginia – The Virginia Department of Medical Assistance Services will host a series of community stakeholder meetings to learn more about how to collectively support current and potential members.