March 2 Update

In This Week’s Update:

  • Updated SHVS Resource Page on Public Charge
  • State Updates: CO, MI, MO, NH, NJ, NY, RI & WA
  • Webinar: Medicaid and Maternal Mortality
  • Effects of Medicaid expansion in Michigan
  • Creating Meaningful Consumer Engagement in Medicaid
  • Addressing the Social Determinants of Health in Children and Families


Updated SHVS Resource Page on Public Charge

Last week, the Department of Homeland Security’s public charge rule went into effect. State Health and Value Strategies (SHVS) has updated its resource page, where you can find all its materials related to the rule, including a new FAQ document that explains whom the rule will impact, what benefits are implicated by the rule, and how the rule might be administered. Additionally, SHVS has added links to resources from California, New York, and Nevada as examples of how these states are communicating the rule to their stakeholders. SHVS will continue to update the page with new resources and account for any developments resulting from litigation of the rule. If your state has developed materials to educate consumers about public charge and you are willing to share them with other states, please reach out and SHVS can post a link to them on its resource page.


State Updates: CO, MI, MO, NH, NJ, NY, RI & WA

  • Colorado
    • Governor Jared Polis and Lieutenant Governor Dianne Primavera released an updated 2020 Roadmap to Saving Coloradans Money on Health Care, which includes the adoption of a public option, the Colorado Health Insurance Option. The Department of Regulatory Agencies and the Department of Health Care Policy & Financing also released details of the proposed formula for hospital reimbursement under the Colorado Health Insurance Option.
    • The Office of eHealth Innovation, the Office of Saving People Money on Health Care, and the eHealth Commission released a request for information to identify solutions and services to prevent and address surprise medical billing, help individuals understand explanations of benefits, and access state benefits and community resources in a timely and coordinated manner.
  • Michigan – Governor Gretchen Whitmer announced that the state filed a motion in the U.S. District Court for the District of Columbia, asking a judge to issue a ruling in a suit brought by four Michigan residents to block the implementation of work requirements for Healthy Michigan Plan coverage. Since the lower court may not rule until later this spring, Governor Whitmer has called on the Michigan Legislature to immediately pass legislation suspending Medicaid work requirements.
  • Missouri – The state submitted an application for a new Section 1115 demonstration that proposes to continue the provision of substance use disorder and mental health treatment services for 12 calendar months after Medicaid pregnancy-related state plan coverage expires. The 30-day federal public comment period will be open from February 27, 2020 through March 28, 2020.
  • New Hampshire – The New Hampshire Joint Legislative Committee on Administrative Rules voted unanimously to approve the new Medicaid to School rule put forward by the Department of Health and Human Services that describes school-based services reimbursable under Medicaid.
  • New Jersey – Governor Phil Murphy released his proposed state budget for fiscal year 2021, which includes creating a state-level health insurer fee to support the state’s reinsurance program and subsidies for consumers purchasing health insurance. In case you missed it, SHVS has a slide deck that dives into the repeal of the federal 9010 fee and considerations for states to enact their own fee to support state health programs.  
  • New York – CMS sent a letter to New York notifying the state that it will not renew its Delivery System Reform Incentive Payment (DSRIP) waiver, and Governor Andrew Cuomo delivered remarks on the potential impact.
  • Rhode Island – The Rhode Island Commission for Health Advocacy and Equity released a report that summarizes data collected through the state’s Health Equity Measures, a set of 15 measures that cover five domains. The report is intended to educate the General Assembly, state agencies, and partner organizations on health inequities in Rhode Island and includes examples of programs and policies in the state and across the country that are showing promise for reducing inequities.
  • Washington – The Washington Health Care Authority (HCA) releasedrequest for applications for the procurement of public option plans offered under Cascade Care. Cascade Care will create new, affordable health insurance coverage options for consumers looking to purchase insurance through the state’s official health insurance marketplace, with coverage beginning January 2021. 


Webinar: Medicaid’s Crucial Role in Combating the Maternal Mortality and Morbidity Crisis

Wednesday, March 11, 2020, 3:00 to 4:00 p.m. EST

The United States is the only developed country where the maternal mortality rate has been steadily rising. Black and American Indian/Alaska Native women in the United States are 3.3 and 2.5 times, respectively, more likely to die from pregnancy-related causes than non-Hispanic white women. Medicaid has a crucial role to play in developing solutions: nearly half of all U.S. births are financed by Medicaid. On March 11, SHVS will host a webinar in which experts from Manatt Health will explore Medicaid strategies to improve maternal health outcomes and address disparities in five key domains: coverage, enrollment, benefits, models of care, and quality improvement.

Registration (required) at the following link:


Effects of Medicaid Expansion: Evidence from Michigan

A new study published in the Journal of Health Politics, Policy and Law uses Michigan as a case study to examine the state-level fiscal impact of expanding Medicaid and how it should be estimated. The authors, researchers from the University of Michigan, evaluated the impact of expansion on the state’s overall budget and economy instead of just focusing on the more straightforward fiscal effects that were estimated by the state budget agency. The authors found that while the state’s savings on other programs are more than enough to cover the cost of the state’s share of the Medicaid expansion in the first five years of the expansion, over time, savings alone are not enough to cover the state’s share. However, when taking into account macroeconomic feedback, such as increased revenue from health care provider taxes and general tax revenues, these outputs were just enough to cover the state’s share of expansion costs. The analysis finds that macroeconomic feedback effects generate an additional $140 million in state tax revenue each year for Michigan. Medicaid expansion is also estimated to increase the state’s population by over 30,000 residents by fiscal year 2021. The authors note that findings from this study could be used to model state-level fiscal impacts of Medicaid expansion in other states.  


Creating Meaningful Consumer Engagement in Medicaid: Perspectives from Colorado and Washington State

In the latest Medicaid Leadership Exchange podcast by the Center for Health Care Strategies, MaryAnne Lindeblad, Washington State Medicaid director, and Tracy Johnson, Colorado Medicaid director, discuss the strategies and challenges they have faced while developing meaningful consumer engagement strategies in their respective programs. During the podcast, the speakers highlight how they provide a range of opportunities for consumers to lend their voice to the program, ensure an environment where consumers feel comfortable to share, and measure success of their consumer engagement efforts.


Addressing the Social Determinants of Health in Children and Families

PolicyLab at the Children’s Hospital of Philadelphia launched a new blog series focused on the role of social determinants of health (SDOH) in shaping the health and well-being of children and families. The series will feature PolicyLab experts and guest authors who are on the front lines of addressing challenging social issues and environments to improve health. The first two blogs are posted. One, authored by Kathy Ko Chin, president and chief executive officer of the Asian & Pacific Islander American Health Forum, writes about immigration status as a social determinant of health and opportunities to address health disparities among immigrant populations. The second, authored by Amber Rich, from the Alliance for the Determinants of Health, describes how her organization is using screening and coordinated care to improve patient health and reduce costs in Utah communities.