In This Week’s Update:

• Center for Medicaid and CHIP Services (CMCS) Informational Bulletin
• State Efforts to Defend Healthcare Accessibility
• Federal Funding Freeze & Primary Care
• New Poll Finds Large Majorities Don’t Want Cuts to Medicaid Spending
• New Executive Directive Unlikely to Impact Medicaid or Marketplace Spending
• State Updates: CA, CO, IL, MA, MN, NC, NH, NJ, NV, NY, RI & WI

 

Center for Medicaid and CHIP Services (CMCS) Informational Bulletin
Last week, the Center for Medicaid and CHIP Services issued an informational bulletin (CIB) that rescinds prior Biden administration guidance on health-related social needs (HRSN). CMS indicates that it is rescinding the prior guidance to “evaluate policy options consistent with the Medicaid and CHIP program requirements and objectives.” The CIB further states that CMS will consider state applications to cover HRSN on a case-by-case basis to determine consistency with federal Medicaid statute and regulations. While the CIB does not directly address prior state 1115 demonstration approvals under this guidance, the Medicaid.gov issued “bulletin” about the release of the CIB states: “Rescinding this guidance does not negate existing approvals.”

 

State Efforts to Defend Healthcare Accessibility
Also last week, SHVS published the latest post in our States of Innovation series. The series highlights what states are working on to achieve better, more affordable and more equitable health for all. This most recent States of Innovation profiles state activity in February, which included states taking action on Medicaid defense, coverage for justice-involved populations, and medical debt. Updates follow.

 

Federal Funding Freeze & Primary Care
In a new article for the Health Affairs Forefront featured topic, “Health Policy at a Crossroads,” Carole Johnson, a senior fellow at The Century Foundation who was previously the Administrator of the Health Resources and Services Administration, discusses the impact of the federal funding freeze on community health centers and highlights three significant threats to the primary care safety net. First, Congress is quickly approaching a March deadline to fund community health centers and another two programs that are the cornerstones of primary care in historically underserved communities. Second, community health centers face devastating cuts if Congress follows through on current proposals to defund Medicaid. Lastly, reductions to the federal workforce threaten the robust partnership between states and the federal government that is key to primary care.

 

New Poll Finds Large Majorities Don’t Want Cuts to Medicaid Spending
Findings from a new KFF Health Tracking Poll finds that as Congress considers changes to the Medicaid program, a small share (17%) of the public say they want to see a reduction in Medicaid spending, with larger shares saying they want spending to stay about the same (40%) or increase (42%). Support for Medicaid spending cuts is relatively low even among traditionally conservative groups, including Republicans (33% favor cuts), people who voted for Donald Trump (35% favor cuts), and people living in rural communities (23% favor cuts). Across each of these groups, larger shares say they want Congress to maintain or increase Medicaid spending.

 

New Executive Directive Unlikely to Impact Medicaid or Marketplace Spending
On February 26, President Trump signed an executive order (EO), Implementing the President’s “Department of Government Efficiency (DOGE)” Cost Efficiency Initiative. The EO introduces new requirements and limitations for “covered contracts and grants,” defined as discretionary spending through “federal contracts, grants, loans, and related instruments.” Last week, SHVS published an expert perspective which discusses the EO and why it is unlikely to impact mandatory healthcare program spending, such as federal Medicaid matching payments (whether under the state plan or section 1115 demonstration), or premium tax credits provided through the Marketplace, including section 1332 passthrough funding.

 

State Updates: CA, CO, IL, MA, MN, ND, NE, NH, NJ, NY, NC, RI, & WI

• California – Covered California, the state’s official health insurance Marketplace, announced the launch of an initiative that will reinvest dollars collected from underperforming health plans to benefit enrollees’ wellness. Known as the Population Health Investments program, the investments will fund programs to help enrollees with chronic health conditions and financial challenges access nutritious food, improve childhood immunization rates for children under two and invest in children’s future higher education expenses, and accelerate population-health management capabilities in primary care practices.
• Colorado – The Colorado Department of Health Care Policy & Financing prepared estimates of the impact of potential federal Medicaid reductions to Colorado. Among other impacts, the report notes that reducing the current expansion population enhanced federal match from 90% to 50% would translate to over $1 billion reduction in federal matching funding annually, impacting the 377,019 Coloradans covered through the expansion population. The report also notes that 96% of Colorado Medicaid’s budget goes to pay care providers, with only 4% going to administration, and that Medicaid is the most efficiently run health plan in Colorado.
• Illinois – Governor JB Pritzker convened leaders and advocates to raise awareness about the critical importance of Medicaid for Illinois families following the passage of the House Republican’s budget resolution targeting Medicaid.
• Massachusetts – The Healey-Driscoll administration announced two standing orders that will allow eligible MassHealth members and Health Safety Net patients to access prenatal vitamins and over the counter oral contraceptives at no cost. The medications in the standing orders will be available through all MassHealth enrolled pharmacies, and pharmacists will be required to provide counseling or guidance on the proper use of both products.
• Minnesota – The Minnesota Department of Human Services released new fact sheets and a communications toolkit about the state’s Medicaid program and Basic Health Program, MinnesotaCare. The fact sheets offer a comprehensive look at the people who receive Medicaid and MinnesotaCare services, how these programs support the state’s healthcare providers,and highlight the potential impact of changes to the Medicaid program that are being discussed at the federal level.
• Nevada – The Nevada Department of Health and Human Services released a report on the estimated impact of potential federal Medicaid reductions to Nevada. Among other impacts, the report notes that a reduction from 90% FMAP for the expansion population to traditional FMAP would translate to a reduction of $1.858 billion in federal matching funds over the next two years, impacting the 300,000 residents covered under expansion. The report also notes that a reduction in a provider tax from a six to a four percent tax would reduce revenue for children’s behavioral health by $30 million in state revenues over two years and lists state options if there are federal reductions, including eligibility and benefit reductions and provider reimbursement rate reductions.
• New Hampshire – The New Hampshire Department of Health and Human Services (DHHS) released the DHHS Roadmap 2024-2025 Mid-Year Report highlighting the department’s work over the past six months and tracking progress implementing the initiatives in the DHHS Roadmap 2024-2025, including efforts to improve recruitment and retention efforts, modernize systems, and streamline processes.
• New Jersey
  • First Lady Tammy Murphy and New Jersey Economic Development Authority CEO Tim Sullivan announced the Commission on Science, Innovation, and Technology awarded a combined $1.7 million in grants to 23 New Jersey-based start-ups focused on developing technology, therapeutics, and other solutions to address maternal and infant health challenges. The grant funds support the research and development of technologies, products, and services to enhance the quality of care and service delivery activities to women, infants, and healthcare agencies.
  • New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman is reminding New Jerseyans without health insurance that they can connect with Get Covered New Jersey, the state’s official health insurance Marketplace, when they file their 2024 State Income Tax return. Residents without health insurance can complete the NJ-EZ Enroll Form to connect to the Marketplace, which will send consumers a welcome notice with an access code to access their account and enroll in coverage.
• New York – Governor Kathy Hochul announced the launch of a new Mobile Medication Unit (MMU) which will provide services in the Central New York Region under the direction of the Office of Addiction Services and Supports. MMUs offer a range of substance-use services, including medication such as methadone and buprenorphine, and are designed to reach individuals who may face barriers to accessing traditional treatment.
• North Carolina
  • Governor Josh Stein sent a letter to Congressional leaders urging them to change course on proposed federal cuts to the Medicaid program and laying out what’s at stake in North Carolina. The letter describes how, in 29 mostly rural counties, 40% or more of the population depends on Medicaid for healthcare. The letter also explains that a cut to the enhanced federal match for the expansion population would trigger an immediate end to expansion leaving 640,000 residents without coverage.
  • The North Carolina Department of Health and Human Services released the 2023 Infant and Child Mortality Data from the North Carolina Child Fatality Task Force Report which shows that non-Hispanic Black and American Indian children have higher mortality rates compared to other racial and ethnic groups. In 2023, the disparity worsened, with Black infants dying at rates three times higher than White infants.
• Rhode Island – Rhode Island General Treasurer James A. Diossa announced that over $7 million in medical debt held by Rhode Islanders has been forgiven through the state’s medical debt relief program since its launch in October. Nearly 3,000 individuals have benefited from the initiative, which has leveraged $50,000 to purchase medical debt from providers. As a reminder, SHVS published an expert perspective and a Health Affairs Forefront article which tracks state medical debt cancellation initiatives, as well as state efforts to prevent the inclusion of medical debt on credit reports.
• Wisconsin – Governor Tony Evers released an open letter to Congressional Republicans, which includes the impact of potential cuts to the Medicaid program in their congressional districts. Cuts to the program would have serious implications for the health and wellbeing of residents, including more than 757,000 people and a loss of more than $9 billion in funding in their districts.