March 20 Update

In This Week’s Update:

  • New SHVS Unwinding Resources
  • Maternal Mortality Data 
  • Most Adults with Past-Due Medical Debt Owe Money to Hospitals
  • Opportunities to Support Early Literacy Promotion in Pediatric Primary Care
  • Oregon Health Authority’s Healthcare Market Oversight Program
  • State updates: DC, IL, KS, ME, MN, MS, NC, OR & RI

New SHVS Unwinding Resources

Last week, State Health and Value Strategies published new resources for states on the unwinding of the Medicaid continuous coverage requirement. A new toolkit features a diagnostic assessment to allow states to evaluate their compliance with federal regulatory requirements for conducting redeterminations and renewals. The tool aims to help states qualify for the sustained enhanced Federal Medical Assistance Percentage and promote continuity of coverage and care during the unwinding. A new expert perspective looks at the three states to date—Iowa, Minnesota, and Utah—that have a public data dashboard to monitor unwinding progress.

Maternal Mortality Data 

Also last week, the Centers for Disease Control and Prevention released data which shows 1,205 pregnancy-related deaths occurred in the U.S. in 2021, compared with 861 in 2020. The data, collected from the National Vital Statistics System mortality file, also demonstrate continued, chilling disparities—the maternal mortality rate for non-Hispanic Black people was 2.6 times the rate for non-Hispanic White people. SHVS recently published a compendium of state strategies to improve maternal health outcomes. 


Most Adults with Past-Due Medical Debt Owe Money to Hospitals

An analysis from the Urban Institute with support from the Robert Wood Johnson Foundation found that more than 15% of U.S. adults report having past-due medical debt, with nearly 73% owing some or all to hospitals. The analysis notes that federal regulation of hospital payment assistance stipulates that nonprofit hospitals must provide charity care and other community benefits to maintain tax-exempt status. But medical debt can become a major issue for patients of nonprofit hospitals because these institutions determine their own charity care eligibility criteria, and financial assistance policies can be difficult to find and understand. Medical debt is a persistent challenge across the country and hospitals are a key source of that debt. Standards and consumer protections are necessary to alleviate debt burdens and improve access to affordable care.


Opportunities to Support Early Literacy Promotion in Pediatric Primary Care

A new brief from the Children’s Hospital of Philadelphia PolicyLab describes how as a regular, trusted touchpoint for families, the pediatric primary care medical home can support early literacy and language development through programs like Reach Out and Read, an evidence-based model that trains medical providers to use children’s books as a tool to connect with families at well visits. Despite the benefits for families, Reach Out and Read is not consistently or equitably funded in pediatric care. Opportunities exist to leverage Medicaid and the Children’s Health Insurance Program (CHIP) for further investment in this model to help raise the standard of pediatric primary care for young children and address disparities in early literacy and school readiness by making these programs more accessible for families. This policy brief—created in partnership with Reach Out and Read and authored by an interdisciplinary group of primary care providers, early literacy researchers, and policy experts—provides recommendations on how states could use Medicaid and CHIP to improve equitable access to Reach Out and Read.


Oregon Health Authority’s Healthcare Market Oversight Program

Research shows that healthcare consolidation leads to higher prices, but many states have limited authority to regulate healthcare markets. In this Milbank report, the authors provide an overview of the Oregon Health Authority’s Health Care Market Oversight (HCMO) Program enacted in 2021 to address the unchecked rise in healthcare consolidation and the downstream effects on cost, access, equity, and quality. The report reviews the elements of Oregon’s HCMO program, which can block transactions or impose conditions on them, and offers insights into the benefits and challenges of implementing a market oversight program based on Oregon’s experience thus far. Although federal oversight of healthcare transactions remains crucial, states have an essential role to play in examining a wide array of healthcare transactions that escape federal scrutiny, whether due to their size or the type of transaction.


State updates: DC, IL, KS, ME, MN, MS, NC, OR & RI

  • District of Columbia – The Department of Health Care Finance (DHCF), the District of Columbia’s state Medicaid agency, announced the start of a public awareness campaign to update enrollee contact information and renew their health coverage. The campaign will include grassroots outreach through neighborhood and citywide events; regular virtual meetings hosted by DHCF on Medicaid renewal; an advertising campaign that touches every Ward in the District that directs enrollees on steps to renew; and a “Stakeholder Communications Toolkit” to assist outreach from community-based organizations, government agencies, and other stakeholders who support and provide services to Medicaid enrollees.
  • Illinois – The Pritzker administration is launching an all-out public awareness initiative to ensure Illinoisans retain their health insurance coverage when Medicaid eligibility verifications resume. The Department of Healthcare and Family Services’ public effort, coined Ready to Renew, is a multi-platform outreach campaign that includes paid advertisements, print, digital and broadcast communication, and grassroots outreach to help Medicaid enrollees ensure they are ready for required upcoming coverage renewals.
  • Kansas – Governor Laura Kelly announced the release of a comprehensive cancer prevention and control plan in Kansas. The plan outlines how the state will allocate resources over the next five years to prevent cancer and reduce the disease’s burden on Kansans who have been diagnosed with cancer and their families.
  • Maine
    • The Maine Department of Health and Human Services published a communications toolkit for community-based organizations, partners, providers, and other stakeholders to inform MaineCare (Medicaid) enrollees about the upcoming renewal process. The toolkit, along with Maine’s unwinding webpage, provides important resources to help inform people with MaineCare about the steps they need to take to avoid losing coverage.
    • The Bureau of Insurance in the state of Maine announced that the Small Business Health Insurance Premium Relief Program has been extended through July 2023, following an additional $6.5 million of funding designated for the program included in the state’s supplemental budget. The program provides premium payment relief to Maine small businesses who are enrolled in a fully-insured, community-rated small group comprehensive health insurance plan.
  • Minnesota – Governor Tim Walz signed an executive order to protect access to gender affirming healthcare in Minnesota. The executive order protects gender affirming healthcare by directing state agencies to take a number of actions, such as investigating and taking administrative actions for unfair or deceptive practices related to the denial of gender affirming healthcare services; preparing a report summarizing the literature on the scientific evidence about the safety and effectiveness of gender affirming healthcare and its public health effects; and declining to help other states that try to penalize individuals and entities seeking gender affirming healthcare services.
  • Mississippi – Governor Tate Reeves signed Senate Bill 2212, which extends Medicaid postpartum care from two to 12 months. As a reminder, SHVS published an issue brief on the American Rescue Plan Act’s option to extend postpartum coverage.
  • North Carolina – The North Carolina Department of Health and Human Services launched an improved QuitlineNC, offering more services and ways for tobacco users to successfully quit smoking or stop using other tobacco products, including vaping and e-cigarettes. Those seeking to quit smoking can now access “Quit Coaches” through live chat or text, watch group videos and create a personalized dashboard to track their quitting progress.
  • Oregon – Governor Tina Kotek announced that she is beginning a search for a permanent director of the Oregon Health Authority.
  • Rhode Island – Rhode Island created a new webpage to inform Medicaid enrollees about the continuous coverage unwinding. The page features SHVS’ Continuous Coverage Unwinding: Enrollee Outreach Video, customized for Rhode Island. Each state can customize the end card of the videos with specific branding elements, such as agency logos, call center phone numbers, and web addresses. If you are interested in a customizable end card, please contact Laura Buddenbaum at