March 22 Update

In This Week’s Update:

  • HHS Secretary Sworn In 
  • Biden Administration Moves To Address COVID-19 Disparities 
  • COVID-19 Vaccines and Emerging Viral Variants 
  • COVID-19 State Updates: CA, CO, DC, DE, MD, MA, NJ, NY, NC, PA 
  • Other State Updates: NJ, NC, OK, UT
  • Lessons From State Balance Billing Laws 
  • State, County, and Local Estimates Of The Uninsured Population

Senate Confirms Xavier Becerra As HHS Secretary 

The Senate voted to confirm Xavier Becerra last week as Secretary of the Department of Health and Human Services and he was sworn in last Friday.

Biden Administration Moves To Address COVID-19 Health Disparities  

The CDC announced a $2.25 billion initiative to address COVID-19 health disparities among groups at higher risk of COVID-19 and under-resourced communities, and HHS released a plan to invest $150 million to expand access to COVID-19 monoclonal antibody treatments for patients in communities disproportionately impacted by the disease. The Biden administration also announced $12 billion to expand access to COVID-19 testing, $10 billion of which is earmarked for schools and $2.25 billion for under-resourced communities.

COVID-19 Vaccines And Emerging Viral Variants 

The National Governors Association released an issue brief that examines the effectiveness of existing and upcoming vaccines against emerging COVID-19 viral variants and provides considerations for Governors. The Biden Administration has set a goal to have 300 million individuals vaccinated across the United States by July 2021 and Governors are at the forefront of this vaccine distribution effort. Adding urgency to this challenge, new and more transmissible COVID-19 viral variants are spreading across the country, increasing pressure on states to quickly vaccinate as many individuals as possible, while ensuring equity and maintaining other mitigation measures to limit viral transmission. The issue brief provides an overview of current evidence about the safety and efficacy of Johnson & Johnson’s recently authorized vaccine and additional vaccine candidates anticipated to receive near-term emergency authorization from the FDA. The brief also addresses the effectiveness of existing and upcoming vaccines against emerging COVID-19 viral variants, including what is known based on interim clinical trial results and preliminary studies and how Governors can address variants in the short- and long-term.

COVID-19 State Updates: CA, CO, DC, DE, MD, MA, NJ, NY, NC, PA 

California – Governor Gavin Newsom and State Superintendent of Public Instruction Tony Thurmond announced a plan to deploy up to 3 million rapid COVID-19 antigen tests at no cost to support the return to in-person learning for staff and students in some of California’s under-resourced school districts, including those hardest hit by the pandemic and those that serve greater numbers of households in poverty, farmworkers and BIPOC communities, as part of an expansion of an existing pilot program for antigen testing in schools. Additionally, the California Department of Public Health announced a new public education campaign to ramp up the connections being made with Californians who have been disproportionately affected by COVID-19 and address questions and concerns they about the vaccine. The “Let’s Get to ImmUnity” integrated media campaign is one part of the state’s Five Part Plan for Vaccination Equity. The campaign is part of a broader $40 million effort that includes radio, print, TV and billboards, with a focus on multicultural and multilingual media outlets. Lastly, Covered California, the state-based marketplace, released new data and announced new partnerships to highlight how the American Rescue Plan can benefit 25 million Americans, including 3 million in California. The agency also released a roadmap describing Covered California’s Approach to Promoting the American Rescue Plan: Target Groups and Strategic Approaches and detailed analysis of those eligible for American Rescue Plan benefits in each state, that includes an analysis of potential marketing investments for the federal marketplace and other states. Finally, Covered California also launched a new SEP that will begin April 12 and run through the end of the year.

Colorado – The state allocated vaccines to community-based organizations across the state and hosted more than 20 vaccination clinics between Friday, March 12 and Thursday, March 18. These clinics focused on vaccinating under-resourced communities in Colorado and span a variety of diverse communities. 

Washington D.C. – In partnership with the Mayor’s Office of African Affairs, DC Health Link, the state-based marketplace, is hosting a series of town hall conversations to address the importance of quality health insurance coverage during a pandemic, health insurance literacy, health insurance and immigration and steps to gain access to health coverage through a COVID-19 SEP. Respective sessions within these unique town hall conversations with DC’s African immigrant community will be held in French, Amharic, and Arabic.

Delaware – The Department of Health and Social Services began a test mobile vaccination effort on March 5 by partnering with the Delaware Transit Corporation to utilize DART’s Paratransit fleet to bring COVID-19 vaccinations to some of Delaware’s under-resourced communities.

Maryland – Governor Larry Hogan announced a series of unique initiatives to ensure vaccine equity and expand the state’s distribution network, utilizing hospitals, primary care providers, and mobile clinics.

Massachusetts – The Baker-Polito administration announced the release of $27.4 million in federal funds to increase trust, vaccine acceptance and administration rates as part of the administration’s Vaccine Equity Initiative and to meet the needs of priority populations. Recognizing equity as a critical component of the state’s vaccine distribution plan, the Department of Public Health is working closely with 20 hardest hit communities in Massachusetts as they identify their specific community needs, further building on existing support.

New Jersey – Get Covered NJ, the state-based marketplace, released an FAQ on the additional financial relief now available to residents as a result of the American Rescue Plan as well as the COVID-19 SEP.

New York – Governor Andrew Cuomo announced 16 community-based pop-up vaccination sites will be online over the next week at churches, public housing developments and community centers. These sites are expected to vaccinate more than 4,500 people throughout the week. As has been the case with previous pop-up sites, these sites will be re-established in three weeks to administer second doses.

North Carolina – In a new PSA  by the North Carolina Department of Health and Human Services, North Carolina NCAA men’s and women’s basketball coaches have come together to urge everyone to take their shot against COVID-19. They talk about why they personally chose to get vaccinated and how that helps to protect others.

Pennsylvania – Acting Secretary of Health Alison Beam issuednew Order requiring skilled nursing facilities to complete a COVID-19 Vaccine Needs Assessment Survey as a way to report essential information regarding vaccination uptake and needs in their facility.

Other State Updates: NJ, NC, OK, UT 

New Jersey – The New Jersey Economic Development Authority issued a request for information seeking insight into food security challenges faced by communities across the state, including specific obstacles and disparities within communities that are considered “food deserts.” Responses to the RFI are due April 12, 2021. The RFI can be found at here. Additionally, Acting Human Services Commissioner Sarah Adelman announced the Department distributed nearly 13,000 doses of the opioid overdose antidote naloxone to county mobile outreach units that provide recovery support services and connect individuals to treatment. The distribution builds on Human Services’ effort during the Murphy administration to make naloxone accessible, including giving 64,000 free doses to residents at pharmacies and delivering 70,000 free doses to police, EMS, homeless shelters, libraries and reentry organizations.

North Carolina – NCDHHS and its state partners released the updated breastfeeding support NC Making It Work toolkit. The toolkit provides clear steps and solutions to business owners, managers and families for supporting breastfeeding mothers at work. The resources in this toolkit are available in English and Spanish. NCDHHS also announced the launch of statewide open enrollment for NC Medicaid Managed Care. Members can enroll online, by calling the NC Medicaid Managed Care Call Center or through the free NC Medicaid Managed Care mobile app. Most people who receive Medicaid can choose from five health plans as part of the state’s transition to managed care.

Oklahoma – The Oklahoma Health Care Authority received federal approval to provide Medicaid coverage and reimbursement for all FDA-approved medication-assisted treatment prescriptions through opioid treatment programs and office-based opioid treatment settings. This will increase access to care for opioid disorder treatment services for SoonerCare members.

Utah – Governor Spencer Cox has appointed Emma Chacon as the Interim State Medicaid Director.

Lessons From State Balance Billing Laws

Georgetown University’s Center for Health Insurance Reforms published an issue brief on state balance billing laws. Under a federal law enacted last year, patients are no longer held financially responsible for surprise medical bills, which typically occur when a health care provider who is not in a patient’s insurance network bills for services at a higher rate than an in-network provider. With support from the Robert Wood Johnson Foundation, the issue brief provides an analysis of experiences in Colorado, New Jersey, Texas and Washington and how they resolve surprise medical payment disputes between health care providers and insurers and offers important lessons for the development of a national independent dispute resolution (IDR) system (as required under the No Surprises Act, which takes effect in January 2022). The authors also examine how differences in these states’ systems, as well as underlying laws and market forces, can affect IDR outcomes and ultimately broader health system costs.

State, County and Local Estimates Of The Uninsured Population

The Office of the Assistant Secretary for Planning and Evaluation developed state, county and local estimates of the uninsured population in the U.S. using the Census Bureau’s 2019 American Community Survey. The estimates include demographic characteristics of who among the uninsured are likely to qualify for coverage through Qualified Health Plans in the marketplace. ASPE also provides estimates of the uninsured population with incomes too low to qualify for QHPs. In expansion states, this population is eligible for Medicaid. In non-expansion states, eligibility for Medicaid depends on specific income thresholds and categorical eligibility, and not all those included in these estimates will qualify.