March 15 Update

In This Week’s Update:

  • American Rescue Plan Signed
  • Public Charge Rule Update
  • COVID-19 State Updates: AK, CO, DC, LA, ME, MN, NC, PA, RI, WI
  • Other State Updates: CT, MN, NY, OR
  • Webinar on American Rescue Plan
  • Updated Health Insurance Marketplace Calculator
  • Medicaid Demonstrations and Impacts on Health Coverage


American Rescue Plan

Last week President Biden signed the American Rescue Plan, a $1.9 trillion budget reconciliation package, into law. The legislation is wide-ranging, seeking to support Americans as the country recovers from the fallout of the COVID-19 pandemic and economic downturn. Health coverage programs will see the largest changes since the Affordable Care Act (ACA), with provisions that will strengthen Medicaid and the Children’s Health Insurance Program (CHIP), dramatically increase affordability in the marketplace, create new coverage opportunities for those who lost jobs, and provide significant federal funding to support states and localities. State Health and Value Strategies (SHVS) is hosting two webinars to address key provisions of the package and considerations for states. The first webinar took place last week and explored changes to private insurance, including the premium tax credit changes and COBRA subsidy and its considerations for state policymakers. A slide deck and recording are available. The second webinar will take place Tuesday, March 16 and will review key Medicaid provisions and state/local relief funding included in the COVID-19 relief package (registration information below).


Public Charge Rule Update

In other news this week, the Trump Administration’s public charge rule is no longer in effect following the Supreme Court’s dismissal this week of a lawsuit challenging the rule. The ruling came after the Department of Justice alerted the Court that it would not defend the Trump Administration’s rule. The Seventh Circuit also dismissed a government appeal in a related case, thereby affirming a district court ruling that vacated the public charge rule nationwide. Subsequently, the Department of Homeland Security released a statement that it will return to pre-Trump Administration public charge policy, which is governed by 1999 field guidance. The 2019 “Inadmissibility on Public Charge Grounds” final rule expanded the circumstances under which an immigrant could be deemed “inadmissible” by virtue of being a “public charge” and has had a chilling effect on immigrants’ use of public benefits.


COVID-19 State Updates: AK, CO, DC, LA, ME, MN, NC, PA, RI, WI

  • Alaska – Gov. Mike Dunleavy announced that effective March 9, the COVID-19 vaccine is available for all individuals who live or work in Alaska and are age 16 and older, making Alaska the first state in the nation to remove eligibility requirements.
  • Colorado – The Department of Health Care Policy and Financing released Health First Colorado Telemedicine Evaluation: An Analysis of Telemedicine During the COVID-19 Pandemic. The report evaluates the telemedicine policy changes Colorado implemented and what is known thus far about their impacts on access to care and utilization, health equity, quality and member outcomes, and payment and reimbursement.
  • Louisiana – The Department of Health is flagging for Medicaid enrollees that if they receive stimulus checks or unemployment benefits during the COVID-19 public health emergency they may need to report the income to Medicaid.
  • Maine – The Maine Department of Health and Human Services (DHHS) announced a new, free option for people who need a ride to and from a COVID-19 vaccination appointment. DHHS is partnering with ModivCare, one of the organizations that coordinates rides for MaineCare members, to provide rides for any Maine resident who is unable to drive, lacks reliable transportation, or is otherwise unable to travel to their appointment.
  • North Carolina – The North Carolina Department of Health and Human Services has expanded its vaccine data dashboard to provide more demographic data on people who are partially or fully vaccinated against COVID-19. Users will be able to see vaccinations by race, ethnicity, gender, and age group by county, by week, and since vaccinations began. The information is displayed on a new tab named “Demographics” on the dashboard.
  • Pennsylvania – Department of Human Services Secretary Teresa Miller announced Pennsylvanians can now apply for the Supplemental Nutrition Assistance Program (SNAP) over the phone. This accessibility enhancement will benefit the growing number of Pennsylvanians participating in the program during times of economic challenges, like the COVID-19 pandemic.
  • Wisconsin – The Department of Human Services is working in partnership with the Department of Public Instruction, the Department of Children and Families, and schools across the state to issue benefits to children missing free or reduced price school means for the 2020-2021 school year.
  • District of ColumbiaMinnesota and Rhode Island – The marketplaces in these three states released statements regarding the federal changes to the Affordable Care Act included in the American Rescue Plan Act of 2021.


Other State Updates: CT, MN, NY, OR

  • Connecticut – Access Health CT, the state’s official health insurance marketplace, recently published Health Disparities and Social Determinants of Health in Connecticut. The report summarizes a data-grounded project designed to identify the needs and opportunities of many communities in Connecticut. The project will allow Access Health CT to build a strategic framework that brings together appropriate public, private, and nonprofit sector entities in support of developing new products, services, and delivery methods that can address health disparities.
  • Minnesota – MNsure, the state’s official marketplace, announced that 2,285 Minnesotans have signed up for private health insurance coverage since the start of MNsure’s special enrollment period on Feb. 16. The three-month special enrollment period runs through Monday, May 17.
  • New York – NY State of Health, the state’s official health plan marketplace, announced that across all marketplace programs enrollment increased by nearly 885,000 people from the end of the 2020 Open Enrollment Period in February 2020 to the end of February 2021. There are now 5.8 million people enrolled in coverage through NY State of Health—nearly one in three New Yorkers.  
  • Oregon – The Oregon Health Authority announced members of the next PartnerSHIP, the decisionmaking body overseeing the 2020-2024 State Health Improvement Plan known as Healthier Together Oregon. The PartnerSHIP includes representatives from priority populations and tribes, as well as agencies and organizations that will implement the plan.


Webinar: The American Rescue Plan: An Overview of Medicaid Provisions and State/Local Relief

Tuesday, March 16, 2:00 p.m. to 3:00 p.m. EST
SHVS will host the second of two webinars to address key provisions of the American Rescue Plan Act of 2021. The second webinar, with experts from Manatt Health, will review key Medicaid provisions and state/local relief funding included in the COVID-19 relief package. Presenters will also discuss considerations for state policymakers as they look to implement the American Rescue Plan, and how some proposals that did not end up in the final legislation could foreshadow future policy priorities.

Registration (required) at the following link:


Updated Health Insurance Marketplace Calculator

The Kaiser Family Foundation released an updated calculator to account for subsidy changes in the American Rescue Plan Act of 2021 (COVID-19 relief). The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges created by the ACA.  With this calculator, individuals can enter their income, age, and family size to estimate their eligibility for subsidies and how much they could spend on health insurance. They can also use this tool to estimate their eligibility for Medicaid. States and organizations can feature the calculator on their websites using these embed instructions. To view an interactive comparison of 2021 premiums and subsidies before and after the American Rescue Plan Act, click here


Medicaid Demonstrations and Impacts on Health Coverage: A Review of the Evidence

A new issue brief by the Assistant Secretary for Planning and Evaluation Office of Health Policy examines policies in four major areas of state Medicaid Section 1115 demonstrations: 1) work requirements (also referred to as “community engagement” requirements), 2) healthy behavior incentive programs, 3) health savings account-like arrangements, and 4) capped federal funding and other financing changes. Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that, in the Secretary’s judgment, are likely to promote the objectives of Medicaid and CHIP. This issue brief reviews the evidence to date on the impact of the above-mentioned demonstration policies on Medicaid coverage and access to care. Multiple studies indicate that Medicaid work requirements can lead to significant coverage losses and worse access to care, without improvements in employment, job training, or other related activities. Other demonstration programs, including those using health savings account-like arrangements or healthy behavior incentives, are frequently confusing and produce administrative challenges for beneficiaries, with some evidence that these harmful effects are larger for people of color.