In This Week’s Update:
- Enrollee’s Experiences With The Unwinding
- Medicaid can improve maternal health
- Pharmacy Availability of Opioid Use Disorder Treatment
- State updates: AZ, CA, CO, GA, IL, ME, MA, MT, NY, SC, WA, WI
Enrollees’ Experiences With The Unwinding
A Kaiser Family Foundation survey of Medicaid enrollees largely fielded prior to states resuming their efforts to redetermine Medicaid enrollees’ eligibility reveals many enrollees are unprepared for the renewal process that could result in some losing their coverage either due to eligibility changes or paperwork issues. The survey found that nearly two-thirds (65%) of Medicaid enrollees were unsure whether states could remove people from the program if they no longer meet the eligibility requirements or don’t complete the renewal process. An additional small share (7%) incorrectly believe that states couldn’t do this. More than four in ten enrollees whose sole coverage is Medicaid say that if the state told them they were no longer eligible for Medicaid coverage, they would not know where to look for other coverage (27%) or end up uninsured (15%). Engaging key stakeholders who can assist enrollees with the renewal process can help increase the number of people who complete their renewals and retain coverage if they remain eligible, or know where to look for and enroll in other coverage if they are determined to no longer be eligible.
Medicaid Can Improve Maternal Health
The U.S. is in the midst of a maternal health crisis as women are dying at rates the U.S. has not experienced since the 1960s. Maternal mortality rates increased by nearly 38% year-over-year from 2020 to 2021 and nearly doubled from 2018 to 2021. States have a number of policy options to combat the crisis and Medicaid in particular should play a critical role. A report from Families USA discusses how states can adopt and expand three powerful maternal health interventions to reverse recent trends: establishing or expanding coverage toward a universal doula benefit, covering all midwives, and scaling up group prenatal care. These policies are particularly impactful because they combat significant drivers of poor maternal health outcomes, namely a lack of centering patient interests and respect, growing maternity care deserts, complications from c-sections, and postpartum depression and other mental health conditions.
Pharmacy Availability of Opioid Use Disorder Treatment
Deaths from opioid-related overdose have remained at epidemic levels for more than a decade without a clear solution in reach. Buprenorphine is a U.S. Food and Drug Administration-approved medication for opioid use disorder (OUD) that can be prescribed in an outpatient setting, including telehealth, and dispensed at retail pharmacies. Despite this, there are some reports that patients may encounter barriers in filling this medication at their local pharmacy. In a study released in the Journal of the American Medical Association, researchers analyzed data from a telehealth OUD treatment provider group operating in 32 states to assess the extent of buprenorphine availability at local pharmacies. Only 57.9% of pharmacies reported buprenorphine/naloxone in stock at the time of request, with substantial differences observed among states and pharmacy chains in the U.S. These findings supplement prior secret shopper studies that suggest pharmacy-level barriers in accessing buprenorphine.
State Updates: AZ, CA, CO, GA, IL, ME, MA, MT, NY, SC, WA, WI
- Arizona – The Arizona Health Care Cost Containment System awarded a $1.6 million grant to launch a psychiatric access line for healthcare providers who care for pregnant and postpartum persons experiencing mental health and substance use conditions. The Arizona Perinatal Psychiatry Access Line (APAL) will connect healthcare providers to a perinatal psychiatrist to discuss their patient’s case and how to provide the best care. APAL organizers also will collect data on trends of perinatal mental illness in Arizona in order to inform state and federal healthcare systems about the best models for care delivery.
- California – Covered California, the state’s official health insurance Marketplace, launched a virtual media tour to spread the word about the upcoming Medi-Cal to Covered California enrollment program and how to keep Californians covered. A new, multilingual ad campaign was also launched to educate consumers and make sure they understand how they can stay insured. The campaign highlights how Covered California will help consumers through every step of their transition, and provide quality coverage, at low or no cost for many.
- Colorado – Lieutenant Governor Dianne Primavera signed several healthcare related bills into law. HB23-1215 increases transparency and implements important protections around hospital facility fees, SB23-284 ensures that health benefit plans that administer contraception coverage provide coverage for 12 months, and SB23-288 expands coverage for doula services in Medicaid.
- Georgia – Georgia’s Commissioner of Insurance appointed Cheryl S. Gardner as the executive director of Georgia’s state-based healthcare exchange, otherwise known as Georgia Access. Cheryl has previously served as chief executive officer of beWellnm, New Mexico’s health insurance Marketplace, executive director of the Arkansas health insurance Marketplace, and director of policy and strategy for the Utah health exchange. Congratulations Cheryl!
- Illinois – Governor JB Pritzker applauded the passage of legislation to lower the cost of health insurance and protect consumers. House Bill 579 establishes a state-based health insurance Marketplace, which will expand healthcare access by allowing the state to effectively identify traditionally underinsured communities, conduct outreach, and assist consumers in the enrollment process. House Bill 2296 institutes the first rate review process in Illinois, allowing the Department of Insurance to approve, modify, or disapprove premium rates in the individual and small group market and increasing transparency for consumers by adding reporting requirements for insurers.
- Maine – CoverME.gov, the state’s official health insurance Marketplace, created a consumer enrollment guide for individuals no longer eligible for Medicaid during the unwinding. The guide instructs individuals on how to create an account, access an existing application that the Department of Health and Human Services may have sent to the Marketplace, enroll in the special enrollment period available for those who lost Medicaid, choose a plan, and access financial assistance through the Marketplace.
- Massachusetts – The Massachusetts Health Connector, the state’s official health insurance Marketplace, will be publishing reports to provide comprehensive and up-to-date information on plan selection, contact center summaries, and enrollment data during the unwinding. The first summary report was published on May 28.
- Montana – Governor Greg Gianforte signed House Bill 872 into law, investing $300 million to improve the delivery of behavioral healthcare in Montana. The investment will support needed repairs at the Montana State Hospital and expand intensive and community-based behavioral healthcare and developmental disabilities services across Montana.
- New York – The New York State Department of Health released a report, Infant Mortality in New York State, 2016-2019, showing during that time period the number of infant deaths in the state declined by 12%. This decline exceeded the overall national decline of 5% during the same period. The data also indicate that racial and ethnic disparities in infant mortality persist. In 2019, the infant mortality rate for Non-Hispanic Black infants was 2.8 times higher than that of Non-Hispanic White infants and Hispanic infants.
- South Carolina – The South Carolina Department of Health and Human Services is warning the community about current Medicaid renewal scams that may target Medicaid members. The state is sending texts to let Medicaid members know their annual review form is in the mail and prompt them to complete the form. Those who receive an email or text asking to pay money or provide gift cards to keep or renew their coverage are instructed to contact the state’s Medicaid fraud hotline.
- Washington – The Office of the Insurance Commissioner released the 2024 proposed rate changes from carriers in Washington’s individual health insurance market. Fourteen health insurers filed an average requested rate increase of 9.11%. The proposed plans and their rates are currently under review.
- Wisconsin – The Wisconsin Department of Health Services has awarded grants for a new program designed to help families and pregnant people experiencing homelessness. Eligible participants include families with children ages 18 and younger and pregnant people with income below 200% of the federal poverty level and no housing. Selected homeless assistance providers will offer a set of supportive housing services, including housing consultation, transition supports, sustaining supports, and relocation supports. Wisconsin is the first state to implement this type of housing benefit through a Children’s Health Insurance Program (CHIP) Health Services Initiative (HSI). The HSI option allows states to use a portion of CHIP funding to implement initiatives that improve the health of children.