In This Week’s Update:
- Racial equity framework for assessing health policy
- Medicaid coverage and costs following the end of PHE
- Gender equity fellowship opportunity
- Expert perspective on unwinding Medicaid Continuous Coverage
- State updates: CA, CO, KY, MA, MI, NJ, NY, TX & WI
A Racial Equity Framework for Assessing Health Policy
Despite enduring racism and the need for greater racial equity, there is limited consensus among analysts, academics, and public officials on how to assess policy for its impact on racial equity. Without instructive conceptual frameworks, our ability to identify, examine, and eradicate racial inequity through health policy will be limited. The Racial Equity and Policy (REAP) framework, created by Jamila Michener, with support from the Commonwealth Fund, provides a conceptually sound, empirically grounded basis for systematically assessing racial equity in health policy. The REAP framework draws on core insights about the policy process and environment to present a set of questions and considerations that policymakers and others should consider when assessing the racial equity implications of policy. In a recent recorded presentation, Jamila Michener explains briefly how the REAP framework can be applied to health policy more broadly. As a reminder, SHVS has a one-stop resource page for states on the topic of health equity.
What Will Happen to Medicaid Enrollees’ Health Coverage after the Public Health Emergency?
A new Urban Institute report includes updated projections of Medicaid coverage and costs following the end of the public health emergency (PHE). The report builds upon a previous analysis on the rise in Medicaid enrollment at the start of the COVID-19 pandemic, mainly attributable to the continuous coverage requirement of the Families First Coronavirus Response Act. In their new brief, Urban projects Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and 2023, assuming the PHE is extended through the first, second, or third quarters of 2022. The authors find that the longer the PHE lasts, the greater the potential number of people losing Medicaid coverage over the 14 months after the PHE ends: 12.9 million if it expires after the first quarter of 2022, 14.4 million if it expires after the second quarter, and 15.8 million if it expires after the third quarter.
Reminder: State Health and Value Strategies recently published an updated Tracking Medicaid Enrollment Growth During COVID-19 Databook.
Fellowship Opportunity: Apolitical’s Gender Equity Learning Exchange
Apolitical is launching a new fellowship for state officials who are looking to apply a gender lens to their work and learn from global approaches to advancing gender equity. The fellowship is a nine-week program that will run from May 9, 2022 to July 8, 2022, with an estimated time commitment of one to two hours a week. The fellowship is both for those already working to advance gender equity and also those who are new to the area. State officials (as well as officials working at the federal and local level) from a variety of sectors (e.g. public health, housing, transportation, etc.) are encouraged to apply. More details and the application can be found here. Applications close on April 22.
Key Takeaways From CMS’ Guidance on Expectations for Unwinding Federal Medicaid Continuous Coverage
CMS released outlines guidance for states as they plan to unwind the continuous coverage requirement, State Health and Value Strategies published an expert perspective summarizing the key takeaways in the new guidance. The expert perspective reviews the timelines and operational strategies states can leverage to mitigate churn and ensure eligible individuals remain enrolled in coverage.
Reminder: SHVS has a resource page for state health officials dedicated to unwinding the continuous coverage requirement where the expert perspective has been posted and where you can find all of our resources on the topic.
SHVS also published an expert perspective on the request for information (RFI) CMS released in February regarding the federal standards that govern access to care in Medicaid and CHIP. The expert perspective summarizes the RFI to assist states as they draft their submissions, which are due by April 18.
- California – The California Department of Health Care Services released Medi-Cal’s Strategy to Support Health and Opportunity for Children and Families, a policy agenda aimed at advancing health equity, stressing whole health and preventive care, providing family and community-based care, promoting integrated care, and improving accountability and oversight for children enrolled in Medicaid.
- Colorado – The state’s official health insurance marketplace, Connect for Health Colorado, reported that more than 6,000 Coloradans have signed up for a health insurance plan using special enrollment periods since the annual enrollment period closed mid-January. That brings Colorado’s total marketplace enrollments for the 2022 coverage year to nearly 205,000.
- Kentucky – The Kentucky Department for Medicaid Services (DMS) is conducting a rate study of home and community-based services (HCBS) programs to develop a sound payment and rate setting methodology.
- Massachusetts – The state’s official health insurance marketplace, Massachusetts Health Connector, announced new health equity initiatives in its 2023 Seal of Approval plan certification process. Starting in 2023, Health Connector coverage will include new benefits, protections, and reduced cost-sharing to advance health equity objectives.
- Michigan – Governor Gretchen Whitmer and the Michigan Department of Health and Human Services (MDHHS) announced a restructuring within MDHHS to improve coordination of behavioral health services. The restructuring will aim to ensure that behavioral health services are supported across community-based, residential and school locations, as well as other settings. The changes will benefit people of all ages, with addressing the needs of children and their families a top priority.
- New Jersey
- Governor Phil Murphy and Acting Attorney General Matt Platkin announced that New Jersey is set to receive $641 million from settlements with Johnson & Johnson, which manufactured opioids, and the country’s three largest pharmaceutical distributors—McKesson, Cardinal Health, and AmerisourceBergen. The $641 million in settlement funds will be paid through 2038 and will fund state and local programs focused on treatment, prevention, and other strategies to combat the opioid epidemic in the state.
- The state recently submitted a request to extend its 1115 waiver demonstration, New Jersey FamilyCare Comprehensive Demonstration for another five years. The state is proposing to continue the current demonstration elements while also seeking authority to add new programs and services such as continuous eligibility for adults, maternal and child health services such as a medically indicated meals pilot program and supportive visitation services, Medicaid covered housing related services, pre-release services for incarcerated individuals, a community health worker pilot program, and a regional health hub initiative.
- New York – The New York State Department of Health (NYSDOH) released for public comment a draft of the New York State Dual Eligible Integrated Care Roadmap which outlines the state’s priority to promote integrated care for Medicaid members who are dually eligible for Medicare and Medicaid, and describes the coordinated initiatives for improving integrated care options across the state.
- Texas – Texas Health and Human Services Commission is launching a $23.2 million public awareness campaign to prevent substance use disorders and help Texans access necessary treatment and services. The substance use prevention awareness campaign aims to reach about 2.5 million people in Texas focusing on reducing stigma, building community connection and resilience, and changing social norms, to prevent substance use.
- Wisconsin – Governor Tony Evers and the Wisconsin Department of Health Services announced a total of 154 Wisconsin National Guard members have completed certified nursing assistant training since early January 2022. This collaborative effort among the Evers Administration, Madison College, and the Wisconsin National Guard was intended to bring needed short-term staffing support to Wisconsin’s hospitals and nursing homes.